Picking your dental insurance is particularly difficult because there are many factors to consider. Factors such as what kind and tips to get the best plan for you can be very difficult. Read on to understand the different types of insurance and also what tips you need to know to pick the right plan.
What is Dental Insurance?
Generally, dental insurance covers a portion of your dental bill. The coverage, however, will depend on your plan. For example, basic plans cover simple procedures like X-rays. Expensive plans cover particularly expensive procedures like implants.
Incidentally, your bill can become unbearable without dental insurance. So then you need the right dental plan to help you pay your bills. Your insurance may not cover the entire bill. In spite of these shortcomings, some coverage is better than none. In fact, the coverage provided by an insurance plan may mean the difference between getting treatment or not.
These plans are less common and above the normal market price. Indemnity plans are usually known as fee-for-service plans because the insurers cap the percentage of their payments. As a rule, the American Dental Association sets your coverage. Consequently, any amount exceeding your coverage is an out of the pocket expense.
For the most part, indemnity plans make you pay a portion of the claims filing cost. After the claim receives approval, you will receive a portion of the filing cost back. In this case, the plan has no network hence more freedom to choose your dentist.
Preferred Provider Organization
For the most part, it is a common type of plan where dentists join a network. They are consequently bound to a fee structure set by your insurance provider. You will have to pay above the usual cost when you visit someone, out of network. These plans can be very expensive in comparison to other plans. They also provide you with flexibility compared to other plans because of their big networks.
This plan is good if you live near in-network providers. On the other hand, Indemnity plans might be a better choice if there are no in-network providers in your area.
Health Maintenance Organization (HMO)
Compared to other plans, this plan only has you pay monthly or annual premiums. The premiums are often lower than other plans but subsequently restrict you to only visiting in-network practitioners. Failure to consult an in-network doctor will consequently have you pay the full bill. It is therefore vital that you find out where the nearest in-network providers are in your area.
Ordinarily, this plan is the cheapest in comparison to other plans. The plan is cheap because all dentists in the network must agree to a fee schedule set by the payer.
Additionally here are a few tips for shopping for your dental insurance:
Check for Group Coverage
Generally, you’ll get dental insurance from your employer, but these plans are not perfect. Additionally, you can also get dental coverage from the Affordable Care Act or public programs such as Medicaid and TriCare.
Employee plans are usually cheaper compared to individual insurance plans but may not provide the proper coverage. Group coverage may have benefits above other plans. As a rule, you must check the specifics of the plan to make sure it’s what you truly need.
Check Individual Policies
Group policies are usually cheaper compared to other plans but may not provide the coverage you need. Individual policies, for the most part, are more flexible and allow you to tailor-fit them for your family’s needs. Before you set your sights on individual policies know that they come with their own massive drawbacks. Namely, being more expensive than group policies. Individual policies also come with more limited benefits and long wait times.
An example of its limits will be if you want to sign up for a policy to get implants, you usually wait for a certain period of time before collecting your benefits. The waiting time may last you anywhere from months to a year however, there are plans with no waiting time. Plans with no waiting times are convenient but consequently cost more.
Before choosing a plan, you must first compare prices from different insurance agencies. Lastly, you can also talk to an experienced insurance agent to help you find what plan suits you best.
Research the Dentists in Your Network
To begin with, you probably have a dentist you already like. Ordinarily, you want to visit the dentist you like, but certain insurance plans may prohibit that choice. You will end up with a high bill if you choose a dentist outside of the network therefore be sure that your preferred dentist is in your plan’s network.
For the most part, insurance plans have their ups and downs. Indemnity plans allow you to see any dentist of your choice but charge more hence the disadvantage. PPO and HMO are cheaper but limit you to a specific network of dentists.
As a rule, you must be careful of dentists who say you need a lot of unexpected work. There are a few dentists that may recommend unnecessary procedures to make up for lost income from the low reimbursement rates. Ask a health professional or friends you trust for recommendations. Finally, you must check the plan for your chosen dentist.
Know The Coverage
Review a dental insurance policy carefully before you make a purchase. To begin, know that cleaning, fillings, and tooth removals are all different procedures. Next, review your needs to get the right insurance. After checking your needs, get a plan that covers what you need, and make sure it’s in your price range. Finally, check what the wait time is for your benefits, or you may not be able to use them.
In the end, you need to know the basics of dental insurance. Next, pick between Indemnity plans, PPO, or HMO. All of these plans have their strengths and weaknesses. Finally, check for the group and individual plans, research your network, and know your coverage to pick the right plan.