Throughout your lifetime, you’re going to want to invest in various types of insurance. This way, you’re financially protected from paying extravagantly expensive bills for things like your physical and dental health. If you’re in the market for dental health insurance, here are some helpful tips to ensure that you get the right dental insurance provider to fit your needs.
Start By Assessing Your Needs
Before you dive into the various types of dental health insurance policies and the companies that offer them, you should start by assessing your needs. Is the dental insurance policy just for you or do you want to put your family all on one policy? The types of coverage are going to vary depending on the plan, so knowing what you’ll likely want to be covered under your insurance policy is a must.
If you have kids, it’s important to note that they are more prone to dental issues as they still have developing teeth. Treatments like braces, fluoride, and sealants are all likely going to be necessary for your child’s oral health. If your kids are in sports, they’ll also likely need a tailored mouth guard to protect their teeth. These are all things that you’ll want to ensure your dental health policy covers.
If you’re an adult looking for an individual plan, there are some common issues that normally affect adult oral health. These include gum disease, replacement of missing teeth, and tooth sensitivity. For those senior citizens, other health issues can spar from poor oral health. Therefore, having a policy that will take care of your cleanings and other preventative oral care is a must. Take the time to make a full list of the treatments that you’ll want your policy to cover. This will guide you along the way to ensure the policy you pick is tailored to your needs.
See What Insurance Providers Have Dentists In Your Area
While a select few may opt for a policy that requires them to travel to their dental appointment, not many people want to do so. Rather, they would like to have a dentist that is in their local area so that they don’t have to invest significant time or gas in getting to their appointments. If you fall into this second category, then you’ll need an insurance company that has a provider in your local area.
A quick look at the website for the various insurance providers that you’re considering should reveal dental health providers in your area. You should opt for insurance companies that have at least a few different providers in your local area. This way, if you find that a specific dentist is not the right fit for you, you’ll have other options. If you pick a dental health insurance provider who only has one covered practitioner in your area, you’re really limiting yourself to one dentist.
Learn About The Different Types Of Plans
There are two major types of dental insurance plans that people have access too. These include DPPO and DHMO dental plans. We’re going to take a look at what each one of these plans is below so that you can better decide which one will best fit your individual needs.
DHMO stands for Dental Health Maintenance Organization plan. It’s commonly referred to as being similar to your traditional HMO health insurance plan for your general doctor. Those who have a DHMO plan will be given a network of providers who they can visit for their oral health needs where they can receive discounted health coverage. Most of this coverage is aimed at preventative visits and restorative care. Here are some of the pros of this type of dental health insurance policy.
With a DHMO policy, you’ll enjoy much lower out of pocket expenses than a DPPO plan. These DHMOs tend to have the lowest monthly premiums of the various types of dental plans that are out there to choose from. Many have no deductibles that will restrict you from receiving coverage. You’ll just be responsible for a small co-pay when you visit your dentist.
A DHMO plan will offer lots of coverage for dental procedures including routine cleanings, x-rays, exams, root canals, extractions, and other restorative procedures. They will even offer some free dental services to their plan participants. With this type of coverage, you’ll never have to worry about filing a claim with your insurance provider. Rather, the participating dentist that you see will file the claim for you.
No Annual Caps
One of the biggest drawbacks of other types of dental health insurance policies is their annual cap limit. Some providers will put a maximum cap amount of money that they will spend on your dental health procedures for the year. If you need more procedures beyond this limit, you’ll end up having to pay out of pocket for the expenses. With a DHMO, you’ll never have to worry about an annual maximum cap amount as they don’t have any.
A DPPO, short for Dental Preferred Provider Organization plan, entails a large network of dental health providers who you can visit for your oral health needs. You’ll be able to receive partial coverage for your dental visits with this type of policy. Let’s take a look at some of the pros that a DPPO can offer potential policyholders.
Visit Any Dentist
One major benefit that a DPPO holds over the traditional DHMO plan is that there is no limitation on the dental health professional you can see. You don’t have to find a dentist in the insurance provider’s network. Rather, you can go to any dentist that you want to. This can be very convenient for those who don’t want to limit their options.
No Referrals Necessary
Unlike with the DHMO plan where you have to get a referral from your main dentist to be covered for a specialty dental visit, with a DPPO you don’t need one. You can see any specialty dentist that you wish without the need for a referral. This is super convenient and allows you to act quickly to get the specialty care you need without having to go through red tape.
Pay Attention To The Deductibles
One major mistake that many individuals make when selecting a dental health policy is not considering the deductible amounts in their decision. Most will look for insurance providers and settle with the one who offers the cheapest monthly premium. However, they come to find out that the deductibles of that particular provider are extremely high. Knowing the out of pocket expenses is a must before deciding on a specific dental health insurance policy.
Each provider should have a list of their deductible for various types of procedures. When you’re comparing the monthly premium from provider to provider, you should also be comparing the deductible amounts for the various procedures. Also, be sure to take a look at the maximum annual limit. Most insurance providers will cap the actual amount of money they will pay for your policy each year. If you or a family member have ongoing dental health issues, this maximum cap is an important number to take into consideration when deciding on the right plan.
Understand What Treatments Are Covered
Not all dental health procedures are covered under a specific oral health policy. Rather, some policies will cover only a limited number of procedures while others may include more expensive procedures. In general, you may find that most dental health insurance policies won’t cover things like dentures and teeth whitening. However, there are a limited number of providers that will.
This is where knowing what your needs are going to be for your dental health comes into play. In MedicareWire.com, you can identify if there are any types of procedures or treatments that you need that aren’t covered by specific providers. This will help you to steer clear of insurance companies that don’t provide the optimal services for you and your family.
Know The Waiting Periods
It may sound a little funny but some insurance companies will require a specific waiting period before paying for procedures. The reality is that they want to ensure they get a set amount of monthly premiums before forking over a lot of money on an expensive procedure that patients need. It’s not uncommon for those who end up needing an expensive surgery who don’t have insurance to sign up for an insurance plan with hopes of getting the procedure paid for.
If you fall into this category, it’s vital that you understand the wait periods. These wait periods will typically vary depending on the type of procedure that you’re going to undergo. Usually, the more expensive the dental procedure, the longer the waiting period. Depending on the dental health insurance provider, some wait periods could be up to 18 full months.
Discover What Specialty Dentistry Is Covered
Sometimes you’re going to run into a problem where your regular dentist is unable to fulfill the problem that you have with your teeth. In this case, you’ll be recommended to a specialty dentist, such as an orthodontist or cosmetic dentist, who can assist you further. While you may think that because your general dentist gave you a referral that you should be covered, that’s not always the case.
Depending on your dental health insurance provider, some specialty dental procedures and visits may not be covered. It’s best to check available policies first to see what types of specialty visits they’ll cover and at what percentage. It’s not uncommon for dental insurance plans to only cover about 50 percent of the cost of a dental procedure for a specialty dentist. Knowing what’s covered ahead of time can help you to financially prepare for the out of pocket expenses associated with your specialty dentistry needs.
Determine If A Plan Requires Upfront Payment
There are many different types of dental health policies out there to choose from. For this reason, it’s vital that you understand how the payment works. With traditional insurance policies, you’re expected to pay a copay for your visit. This copay is a small percentage of the overall cost of the procedure or visit. Your dentist will then send the remaining bill to your insurance company to pay. However, in some cases, insurance providers can require you to foot the initial bill. Then, you send your receipt to your dental health insurance provider for reimbursement. These types of plans are typically enacted by providers who allow patients to go to any dental professional in their area.
These plans can be convenient for those who don’t want to worry about finding a dentist that is part of a specific network. However, realize that you’ll be footing the entire bill, so you’ll need to have the cash on hand. In addition, anything that was not covered according to your policy, you won’t get reimbursed for. With this type of plan, it pays to know what your coverage is from top to bottom to ensure that you get reimbursed for the amount you believe you should be.
Set Your Budget
While there are many different types of oral health insurance policies out there for you to choose from, it’s unlikely you can afford them all. Knowing what your financial limitations are can steer you in the right direction when it comes to coverage. It’s a good idea to take a look at your monthly budget and determine just what amount you can comfortably afford to invest in your dental health insurance payment.
Finding the right dental health insurance company is not something you want to skip over. Rather, there are various health insurance providers out there who are all offering different variations of coverage options and plans. You should be utilizing the tips above to ensure that you find an insurance provider that fits your needs and budget.