What Is Dental Insurance
Many seniors assume dental insurance is health insurance for your teeth. While dental insurance does share some similarities with health insurance, there are some major differences between the two that you should understand.
Like health insurance hospital coverage, dental insurance does cover emergencies, such as breaking a tooth or getting an infection. Also, like medical coverage, most dental plans cover preventive care.
The big difference between health insurance and dental insurance is how much coverage the policies provide, and how that coverage works.
Consider The Alternatives Of Dental Insurance
When thinking of assistance to help with the cost of dental treatment, insurance is probably what patients think of first. However, there are alternatives to dental insurance that can synergize with dental insurance plans or serve as a standalone option. Depending on your circumstances you should also consider utilizing a Health Savings Account, a Flex Savings Account, seeking a dentist that has an in-house discount plan, or using a dental financing company that can break payments over a period of several months such as the Lending Club or CareCredit.
If Possible Get Coverage Through Work
Getting dental insurance through your employer makes sense for most people: employers get lower group rates because they are buying benefits for many employees at once. Also, group plans often feature higher coverage levels, and the company may pay a portion of the costs, making it an even better value. If you can’t get group-rate insurance at work, check to see if you can get coverage through a professional association or other membership groups.
However, if you need to get insurance as an individual, that’s not a problem. It’s still affordable and many dental insurance carriers, such as Guardian, let you compare, get a quote, and buy coverage conveniently online.
Also Check: Travelocity Travel Insurance
The Pros Of Dental Membership Plans
Our dental membership plans cover preventive care in full, just like dental insurance does. The adult plan covers treatments that many dental insurance companies dont cover fully for adults, such as two fluoride treatments a year. It also covers two periapical x-rays and one set of four bitewing x-rays each year, as well as any individual x-rays you end up needing throughout the year. Youll get a 50% discount on limited evaluations and CBCT/3D Imaging, and 20% off any other service we offer. This means that youll have discounts and lower out-of-pocket costs on treatments that dental insurance wont cover at all, from tooth-whitening treatments to a dental implant.
While these details are specific to our dental health club, most dental savings plans follow a similar outline. Choosing a dentist you love and then signing up for their dental savings plan gives you more freedom in your dental care because youre able to choose the Duvall dentist you like best. You also dont have to worry about whether or not your insurance will deny coverage for treatmentswhether theyre necessary or elective. This gives you the freedom to choose the treatment that fits your goals best.
Dental Insurance For Dentures Braces And Bridges
Dentures, braces, and bridges are other types of dental treatment that are not deemed medically necessary. However, dentists will advise these treatments to enhance the appearance and function of your teeth. So, you can find insurance plans that cover them.
The best dental insurance for major denture work can be obtained from Delta Dental, where you can find full coverage dental plans with no waiting period. You can start your treatment right away and be covered from the get-go.
Read Also: Securedent Denture Implant System Cost
What You Need To Know About Dental Payment Plans
These plans spread the cost of your dental care over a year, theyre sometimes known as capitation plans.
You can sign up for treatment at different levels:
- Level one covers routine care, such as check-ups, scale and polish, X-rays and fillings.
- Level two includes restorative treatment as well, such as crowns and root canal fillings.
There are flexible plans designed especially for children, and plans that include cover for dental injuries and dental emergencies on a worldwide basis.
The monthly average costs the same as the more expensive dental insurance policies. If your teeth are in good condition, youre probably better off on the NHS.
With a dental plan, youre tied to a particular dentist. A referral to a specialist, such as an orthodontist, wont be covered.
If you change dentists when you move to a new area, for example you might have to start the process again. This means the amount you pay might have to go up.
Types Of Dental Insurance Plans
Dental insurance companies want to know wholl be working on your teeth before providing coverage. Most companies have a network of pre-approved dentists. In other words, when you sign up, theyll provide a list of dental offices in their network that are close to you.
Therell be benefits to staying inside of the insurers network but at the end of the day, Its up to you to choose which dentist is best for you.
Like other forms of insurance, the type of dental insurance plan you end up going with will depend on a variety of factors.
- How often do you plan on going to the dentists office?
- How much are you willing to pay for dental insurance?
- Do you currently have good oral hygiene?
- Does your family have a history of oral cancer?
These are questions you should ask yourself before signing up for your first dental insurance plan.
Also Check: Ail Scam
Medical Insurance May Help
Dental insurance provides benefits for treatment that is considered dentally necessary, and medical insurance provides benefits for treatment medically necessary. So can medical insurance help cover dental treatment that is medically necessary? You bet it can.
But not so fast, before you start asking your dentist to bill you medical insurance for your next filling or crown, you need to understand, the primary cause has to be medically based. If the problem is due to only a tooth, it wont be covered by medical insurance. Common dental conditions that may crossover to create medical necessity, and thus potentially have coverage by medical insurance are trauma from an accident, dental deterioration from a severe systemic medical condition or medication, TMJ dysfunction, removal of wisdom teeth, and sleep apnea.
Of course every situation is unique. If you have questions feel free to or visit our website for more information.
Dental Insurance: An Ounce Of Prevention Is Worth A Pound Of Cure
All my life, Ive been hearing about this pound of cure. How much does it cost by the pound?
Most dental insurance plans cover routine cleanings and checkups at no additional cost to the patient. Dental insurance clearly believes in preventative care. Dental issues can escalate very quickly, so everyone, ideally, should have preventative 6-month checkups. And prevention is not just about the mouth, according to the Oral Health Foundation, people who have lost 5 or more teeth by the age of 65 years are more likely to suffer from cardiovascular disease, diabetes, and osteoporosis.
Essentially, studies now show that poor oral health affects overall health, and dental insurance clearly gives merit to this concept. Therefore, dental insurance plans are great for routine general dentistry such as hygiene visits, exams, and minor restorative dental treatment each year.
Read Also: Does Homeowners Insurance Cover Windows
What You Need To Know About Dental Insurance
- Dental insurance policies cover routine check-ups, as well as the costs of all dental work. This includes dental accidents and emergencies.
- You can often have the work done at either an NHS practice or a private clinic.
- If you use an NHS dentist, youre more likely to get back 100% of the cost of your treatment.
- If you cant see an NHS dentist, youll only be paid back a percentage of your treatment costs.
- You pay the dentist first, then claim back your money. You can normally only start to claim between one and three months after you buy the insurance.
- There are usually annual limits on how much you can claim for certain treatments.
- If you havent been to the dentist in the past 12 months, your policy might not pay for treatment identified at your first check-up.
- Cosmetic dental work, such as teeth whitening, isnt generally covered.
- Most policies have an age range that starts from age 18 although some start at age six.
- Some policies offer a no-claims discount. So the cost of your premium will increase if you make a claim for anything other than a standard check-up.
If You Can’t Afford To Pay Anything For Dental
If your budget doesn’t allow you to see the dentist, look for free care opportunities in your community. A great place to start is Oral Health America’s Tooth Wisdom website. Oral Health America is a non-profit organization whose mission is to help seniors get affordable dental care from local dentists, health care clinics, and dental schools.
Also, check out the Dental Lifeline Network. This national charitable organization helps older people connect with healthcare providers that have pledged to offer seniors low-cost or no-cost dental care. To find out more, visit their website.
Read Also: Can I Get Sr22 Insurance Without A Vehicle
Is Dental Insurance Worth It
Now, you may think that most people dont come out ahead with most kinds of insurance, and you may be right. After all, if insurance companies didnt make a profit, then they would all go out of business. Insurance is designed to protect you in a worst-case scenario.
Dental insurance is significantly different from most other kinds of insurance, however. With health insurance or homeowners insurance, for example, the potential downside is so high that almost no one can afford the risk of not being insured. With dental insurance, the potential downside is fairly lowas is the potential upside.
In a good year, when you only need the standard cleanings, exams, and X-rays that make up good preventive care, you could lose money by having dental insurance. For example, if you paid out of pocket for these services, you might spend around $400 for the year, whereas you might spend $600 for the year on insurance premiums.
Older adults represent a group that may find it worthwhile to enroll in a dental insurance plan. Dental insurance for seniors is similar to plans for other individuals but focuses on the types of coverage that seniors may need. These include crowns, root canals, dentures, and tooth replacements. Even though these coverages are not unique to older individuals, there is a higher probability that seniors will need one or more of these procedures. Note that seniors on Medicare may require a different dental insurance plan than those without it.
How Much Coverage Does Dental Insurance Provide
Dental plans require you to pay many of the same out-of-pocket costs as regular health insurance, including a monthly premium, a deductible, copays and coinsurance.
The coinsurance you pay will likely be more than youre used to paying. For example, Medicare beneficiaries are typically responsible for 20% coinsurance, but its not unusual for dental plans to require 40% coinsurance or higher.
Another important factor to consider is that dental insurance plans often have a cap , and its usually very low . After you meet the maximum, youll pay for 100% of the cost of your care.
For years when preventive care and a filling or two are the only services you need, that works just fine. But if you need more than very basic dental work, you will quickly exceed that benefit. For example, the cost of a root canal and crown together can be upward of $3,000.
There are plans that have no annual limit, but be aware that even dental insurance that bills itself as comprehensive or full coverage almost certainly will not cover 100% of the cost of your dental care.
Cost Of Dental Insurance
The average cost of dental insurance is around $360 per year. However, plans vary depending on the coverage you choose, so prices differ between $15 to $50 a month.
Furthermore, the average cost might differ for certain groups of people due to age and/or location:
- Seniors: around $29 per month.
- Employees: between $14 and $30 per month.
- Family of four: $112 per month.
Examples of the average price difference depending on location:
- Canada: between $30 and $60 per month.
- California: between $20 and $50 per month.
The average cost of dental insurance truly does depend on age, location, employment, and group discounts.
Purchasing Dental Insurance & Average Cost
As with any insurance-related decision, it is a good idea to do comparison shopping before finalizing anything. Some factors to weigh when comparing insurance policies include:
- Think about the dental needs of everyone in your family. For example, do you have kids who might need braces?
- When youre choosing a plan, youll want to make sure it allows you to pick from multiple care providers. Some plans may only have one dentist or one dental practice in your area, so youd be very limited.
- While most routine treatments are covered in all dental insurance plans, as you compare, you want to look at whats specifically not covered.
- Some dental insurance plans have waiting periods, and these can be lengthy in certain cases. For example, some dental insurance plans require a waiting period of up to 18 months before more expensive procedures are covered.
- You have to think about all of the costs when youre comparing dental insurance companies. For example, you might first think about the premium, but there are also deductibles to consider as well as maximum yearly limits.
Most dental plans cost around $30 per month, but this only reflects one part of the costs you need to think about as youre looking at plans. If your employer offers a group plan, this is more than likely going to be the cheapest option available.
Don’t Miss: Will Insurance Cover Broken Car Window
Do You Need Dental Insurance
It makes sense to get your dental treatment subsidised for free through the NHS. But if you’re unable or unwilling to use an NHS dentist, or you need to have a lot of work done on your teeth, dental insurance might be a good idea. Find out about the main types of dental cover, how it works, when it might be suitable and the costs.
Why Do Some Patients Wonder If Dental Insurance Is Worth It
These days household budgets are stretched to the max, so people might wonder if paying a monthly premium for dental insurance is worth it when they need to make every dollar count. You may be paying hundreds of dollars per month for medical insurance and you might think that paying more, even if its a minimal amount, for dental insurance may not be worth it.
But your dental health affects your overall health and not taking care of your teeth may lead to serious health problems down the road. Often mouth infections can be the first symptom of what might be chronic illnesses like diabetes¹ and your dentist can be crucial in identifying a potential health problem by noticing chronic infections or changes in your teeth and gums. Dental plaque and mouth bacteria also can be factors in serious health conditions like heart disease and stroke.² Getting regular dental checkups and cleanings can help lower your risk of health problems later.
Some people also might prefer to pay out of pocket if they need dental care and not pay a monthly premium, hoping that they wont have an expensive dental emergency. But if you get regular dental care you may be able to avoid an expensive and painful dental emergency. The out-of-pocket cost of routine care could add up quickly.
Don’t Miss: Is A Broken Car Window Covered By Insurance
When Dental Insurance Might Not Be Worth It
Many people find they end up losing money with dental insurance rather than saving any.
For instance, if you have healthy teeth and no unusual dental needs, annual dental insurance may not be useful for you. Except in the case of an emergency, youll be paying money into a plan that you almost never use.
Additionally, extra dental insurance outside of whats offered by your employer is typically unnecessary. Employer dental benefits typically cover between25 to 80 percent of normal treatment costs like cleanings, crowns, and fillings. In fact, those with great dental health may be better off skipping dental insurance offered by their employer altogether. To determine if your jobs dental insurance is worth it, look over the monthly payments, annual maximum, and coinsurance.
Signing up for dental insurance when you already need an urgent dental procedure is also often useless. There is typically a delay before dental insurance benefits kick in. For major procedures, you may have to wait a full year before your insurance would help with costs. This delay means you either have to pay completely out of pocket for your procedure or wait a significant amount of time to get your work done. If you wait too long on a crucial dental issue, you can cause more oral health problems that will be pricey later.
Look For Coverage That Matches Your Needs
Top-tier insurance companies, such as Guardian, offer a range of options. Some plans focus on providing preventive and basic coverage, and other plans offer more comprehensive coverage, which includes things like implants and orthodontics. If you’re young, single, and your teeth have never given you problems, a basic plan will offer lower premiums. If you have children and especially if they have crooked teeth consider more comprehensive coverage.
You May Like: Trustage Reviews
When Dental Insurance May Not Be Worth It
Scenario 1: Your Employer Offers Dental Benefits
For most people, employer-offered dental benefits are more than comprehensive enough to cover routine dental treatments and care.
Depending on the specifics of your dental plan, your employers dental benefits probably cover between 25% to 80% of the cost of normal treatments like cleanings, root canals, crowns, and fillings. If you do not have special dental needs, these benefits can actually be more beneficial to you when you subtract the cost of premiums and deductibles.
Scenario 2: You Need an Urgent Dental Procedure
Do you have an urgent dental issue and think that signing up for dental insurance will help lessen your burden? Not so fast. Dental insurance enrollments often have a long waiting period, in addition to a delay to when your benefits kick in.
This means that if your motivation for seeking dental insurance is a problem you have right now or an issue that will need to be addressed quickly, you may end up further compromising your oral health by waiting to sign up for insurance.
Scenario 3: Your Dentist Does Not Accept Dental Insurance
Unlike health insurance, dental insurance is not widely recognized or accepted. If you arent willing to shop around for a new dentist, youll want to before you enroll.
Scenario 4: You Do Not Have Unusual Dental Needs