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Discount dental plans come in many varieties, so you need to understand what you are getting before deciding on a plan.
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Below is a video from eHealthInsurance discussing dental coverage.
Benefits - The purpose of dental insurance is to provide affordable access to dental care. A typical policy will provide for both preventative care and major dental procedures, while some plans offer orthodontics coverage as well. | |
Cleanings - Typically an insured can have their teeth cleaned semi-annually at no additional charge (no co-pay, co-insurance, or deductible apply on most plans). | |
Filings, Crowns, and Root Canals - Major dental procedures are generally covered, though a deductible, co-pay and/or co-insurance may apply. | |
Teeth Whitening - Elective procedures, including teeth whitening, are typically not covered. | |
Dental Implants - Elective procedures, including dental implants, are typically not covered. | |
Cosmetic Dentistry - Elective procedures, including cosmetic dentistry, are typically not covered. | |
Annual Maximum Benefits - Most dental insurance plans have a maximum benefit amount they will pay for each covered individual for each contract period (typically one year). This amount usually ranges from $500 per person to $2000 per person. | |
Deductible - Many PPO and indemnity type dental plans require the insured to pay an annual deductible before the plan starts to cover claims. This amount can be per person, per family, or per plan, and typically ranges from $50 to $150. | |
Co-Pay - The amount that the insured is responsible to pay for a dental procedure (x-ray, exam, cleaning, filling, crown, etc.) and is expressed as a dollar amount. Co-pays range from none ($0) to hundreds of dollars, depending on the procedure, although preventative care items usually have a low co-pay. Typically, an HMO dental plan will have co-pays and will not have a deductible or co-insurance. | |
Co-Insurance - The amount that the insured is responsible for after any deductible and/or co-pay has been satisfied and is typically expressed as a percentage. For example, with a 20% co-insurance, the insured would be responsible for $20 of a $100 procedure, with the insurance provider covering the remaining 80%. Typically, an indemnity or PPO dental plan will have co-insurance. | |
Provider Network - Most dental plan types have a preferred provider network of dental professionals, from which you receive dental care. HMO dental plans require you to see a dentist within the plan's network, and will not pay for care done by an out-of-network provider. PPO dental plans use a network of dentists, but also allow you to seek dental care from outside of the network. However, when using an out-of-network dental provider, the insured may be responsible for the amount above what the insurance company would reimburse an in-network provider (which is usually a contractually negotiated reduced rate). If you currently have a dentist, choose a plan that they accept so that you can take full advantage of your coverage. | |
Waiting Periods - Most dental plans have a waiting period (6 to 12 months) for major procedures, such as crowns, root canals, and, sometimes fillings. There is typically no waiting period for preventative care, such as cleanings. If you suddenly find that you need a crown, and do not have a dental plan, you will not be able to buy coverage today and have the plan pay for the procedure, due to the waiting period. | |
Eligibility - It is fairly easy to qualify for dental coverage. Most individuals, and their eligible dependents, will qualify for coverage. | |
Affordability - In most states, dental coverage is relatively inexpensive, with plans starting under $20 a month in many locations. Get a free, no-obligation quote today by visiting eHealthInsurance's website. | |
Coverage Through Health Plan - Most major medical plans do not offer dental coverage - you will need to purchase a separate dental plan. |