Whether you’ve recently started a new job or you’re considering changing your dental insurance plan during open enrollment, it’s not uncommon to feel a little overwhelmed. After all, unlike medical or auto plans, when it comes to protecting your smile, dental coverage does things a little differently. Here’s a closer look at what you should know when picking a new policy, so you can make the best choice for you and your family’s smiles!
Prevention is Key
Although they’re all considered insurance, dental coverage differs from other types of plans because it’s designed to be preventive. That means that instead of waiting for a problem to occur, the emphasis is placed on caring for your smile in advance so you’re less likely to have issues later. This is why most policies cover two dental checkups and cleanings each year and may even include X-rays and fluoride treatments. While these packages typically still offer deep discounts on procedures such as fillings, root canals, and extractions, by encouraging prevention now, your dental insurance provider hopes you’ll be less likely to need these costly repairs later.
Restorative Coverage
Although your provider would prefer to prevent oral health problems from day one, it’s important to choose coverage that will still protect your smile if something goes wrong. In most cases, dental insurance plans will cover about 80 percent of what is known as “restorative” care, including things like fillings and extractions, leaving you responsible for the 20 percent balance out of pocket.
Major Restorative Procedures
Hopefully, you never require a major restorative procedure. However, when choosing a dental insurance plan, look for one that covers a minimum of 50 percent if you do. Treatments that fall into this category include things like dental implants which without insurance can cost between $3,000 and $7,000 for a single tooth, meaning at a 50 percent coverage level, you’d only be responsible for about $1,500 to $3,500 out of pocket.
Orthodontics (Not?) Included
Braces and aligners can be very expensive, and orthodontic coverage isn’t typically offered as part of most basic dental insurance packages. However, it may still be possible to purchase what is known as a rider policy, which will pay for some portion of you or your family members’ orthodontic care. The exact level and which treatments are covered will depend on the individual rider you select, and of course what your dentist or orthodontist deems medically necessary for your smile.
Worth the Wait
Although it’s not true for every dental insurance plan, some policies start with an automatic waiting period. This is to prevent patients from buying a plan, using the benefits, and then canceling once they’ve restored their smile. The good news is that most preventive care is available immediately; however, some treatments have a delay of about 30 days before you can use your coverage. Furthermore, more intensive restorative procedures may have to wait up to 90 days, and coverage for major procedures could be put on hold for up to six months. Regardless of any waiting period, be sure to verify your benefits first, as some plans might limit the number of treatments you’re allowed in a given calendar year.
Remember, with costs high and numerous studies showing how essential excellent oral health is to live a long, healthy life, having dental insurance coverage is more important than ever. Whether you are just choosing your first plan, or you’d like to shop around and see if you can get a better deal when protecting your teeth and gums, keeping the above information in mind can help you save time, money and your smile!
About Dr. Tran
For over 15 years, Dr. Hoa Tran has proudly protected the smiles of Houston patients, offering a wide range of dental treatments from preventive to orthodontic. At WellSmiles DYNTL at Greenway, we are proudly dental insurance friendly and are in network with all major PPO plans. To verify coverage and save money on your oral health care by using your dental insurance to safeguard your smile with us, visit our website or call 713-437-3902 today.