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Dental Insurance Explained
It’s important to note that dental insurance does not work the same as medical insurance. Dental insurance can be purchased as a stand-alone policy or as and add on to medical insurance plans. As with most things, the cheaper the policy, the worse the benefits and coverage. While most patients with dental insurance don’t have the choice of which plan their employer provides, it is best to do your homework before considering purchasing a plan on your own. So, how does dental insurance work as compared to medical insurance? Let’s take a look.
Dental plans have yearly maximums that range from $750 to $2,000 per year. Of course, the higher the maximums, the more expensive the plan. Most all plans cover preventive (cleanings, x-rays, etc.), basic (fillings, emergency visits) and major (crowns, dentures, etc.). Preventive procedures are usually covered immediately with a new plan but most basic and major procedures have a waiting period anywhere from six months to a year before coverage starts. This is to make sure the insurance company profits off a new policy and discourages people from getting a plan for work they know needs to be done immediately. There are also many procedures that are not covered at all including any cosmetic procedures, most all dental implant procedures, and most will not cover pre-existing conditions, such as missing teeth.
So, what if you get a new plan and your current dentist is not on the provider list?
Do you have to change dentists?
Of course not.
Providers on an insurance list are ones who have agreed to work for the insurance company at a lower fee in exchange for access to potential new patients. Only the cheapest plans will have exclusions where you cannot see any other dentist except for the ones on the plan list. Most decent plans will allow you to see other dentists not on the plan list but will not pay as much.
Why is this?
The insurance companies are still going to make the same amount of money for themselves but when a dentist signs on with an insurance company, the dentist agrees to accept lower fees. This is how coverage is higher if you see a dentist on their list since they do not pay the dentist as much. For most dentists on insurance lists to make up for lower reimbursements they will have to see many more patients which could lead to longer wait times and compromised patient care. For the dentist payroll and business overhead stay the same so something has to give.
As an alternative to dental insurance some dental offices may offer a loyalty or discount membership. These memberships are designed to offer discounts off dental procedures, even those not covered by dental insurance. This option may me much more appealing than dental insurance since you only pay for what you actually need. Visit our website to see what our Loyalty Membership has to offer.