Why you need a dental insurance ?Dental Insurance is designed to pay the costs associated with dental care. Dental insurance offers a protection from unexpected dental expenses by paying all or a portion of the bills from dentists, and other providers of dental services.
Most of us will need some kind of major dental work sometime in our lives. A dental insurance can help to deal with the cost of dental care without compromising our health by leaving any problems untreated.
How to choose a dental insurance ?There is a large number of factors that can affect your choice of a dental insurance plan. The importance of each factor should be based on your individual needs. Some of them may be more or less important for you than for someone else.
The cost you have to pay for your insurance is always important. But keep in mind that the lowest price is not always the best price. Never choose the lowest cost plan before examining all the other factors described in this page.
All normal dental procedures, such as 6 month cleanings, dental fillings, root canals, in-depth check-ups, x-rays should be fully covered under your plan. Most insurance plans do not cover cosmetic dental procedures. Other procedures like braces may be covered from some policies but upto a certain limit. Coverage of certain procedures such as implants and braces may justify a higher monthly premium. Learn exactly what is covered before making your decision.
Maximum annual limit
The majority of dental insurance plans cap the amount of reimbursement to an annual maximum that is usually $1,000 to $1,500 per year. You will be responsible for any costs beyond that amount. Some insurance providers offer special plans with higher annual limits up to $3,000, which despite their higher premium may be more suitable for individuals with bad dental health. Some plans have a limit not only in the amount covered but also in the number of certain procedures allowed per year.
Usually, insured individuals must meet their deductible before the dental insurance company begins to cover their dental care, so the cost of deductibles should be considered when calculating the overall costs associated with dental insurance. Annual deductibles can vary from $25 to $50 per covered individual, depending on the dental insurance policy.
Dental insurance plans have exclusions on pre-existing conditions or impose long waiting periods from 6 to 18 months before paying for major dental treatment. This could be a serious problem if you need some serious dental work in the near future.
UCR (Usual, Customary & Reasonable) indemnity dental insurance plans will check the cost of your treatment against the average cost from other similar treatments in their database. If the cost of your treatment is lower than average you will receive the agreed percentage of the amount you paid. If you paid more than the average you will have to pay the additional cost on your own.
Choice of treatment
The most common clause used by dental insurance companies to allow them refuse to pay for expensive treatment that you may need, is a term called “least expensive alternative treatment” (LEAT), also known as the least expensive professionally acceptable treatment clause. Under a LEAT clause, when there are multiple viable options of treatment available for a specific condition, the plan will only pay for the least expensive treatment alternative.
Choice of dentist
Make sure that the dental insurance plan allows you to choose your own dentist. Many plans will force you to choose one of the dentists participating in their own network. Even though insurance providers claim that they work only with the best quality dentists, you might not feel comfortable with the proposed dentist.
Family members covered
If you have a family you should choose a family plan. Ask how the various restrictions (deductible, annual limit etc) are implemented; by individual member or in total. If you have children check if fluoridation, sealants or braces are covered.
Nearly all dental insurance policies will request you and your dentist to fill a number of forms, every time they have a claim. Ask for more details if you want to avoid a time consuming claims process.
A good dental insurance policy can help cover the costs of dental treatment whether it be an emergency or a routine check up, meaning you never have to worry about the cost of keeping your mouth, teeth and gums healthy.
Before you take the final decision and choose a dental insurance make sure that you have asked for what is exactly covered in each case. Compare policies so that you get the best value for your money depending on your own needs.