With the end of the year rapidly approaching, it’s a good time to discuss dental insurance as you may be considering enrolling in a new plan or looking to maximize your dental benefits.
Generally speaking, with the exceptions of Medicaid, Medicare and Apple Care plans, patients have a choice between PPO and HMO plans. If you are considering a new plan, you should know that PPO plans offer the most flexibility. These plans allow you to choose whichever provider you want to see, as opposed to HMO plans, which require that you choose from a list of their pre-approved providers.
Although you can choose any provider you would like with a PPO plan, you will get the best value and lower rates if you select a dentist that is on your insurance providers’ list of “preferred providers”. This is because a preferred provider has agreed to a lower reimbursement from your insurance company than what they might otherwise charge someone that does not have insurance or does not have that same plan.
Now, dental insurance tends to be fairly limited. It functions very differently than medical insurance. Medical insurance, for instance, can have a much higher deductible that must be reached before your plan really begins to assist with coverage. Dental insurance, on the other hand, usually has very low deductibles (if any) and will pay a much bigger percentage of procedures up to a much smaller maximum. This is a general outline, of course, and does not include the dental plans that are only meant to cover hygiene visits and nothing else.
Most dental insurance plans offer maximum coverage of approximately $1,500-$2,000 annually. These maximums have not increased for many years, although premiums have continually increased. When it comes to dental work, especially if you have extensive work, this maximum is used up fairly quickly. This has led many patients to consider whether dental insurance is even worth having. Although the answer to that question depends on your personal situation, something to consider is that preferred provider rate mentioned previously. Even if you reach your dental insurance maximum, if you are under a PPO plan with a preferred provider, you still will receive lower fees for services – which can amount to thousands of dollars in savings!
Having dental insurance also creates an incentive to seek regular dental care which, hopefully, will help you to avoid small concerns from becoming much larger and costly dental issues. However, dental insurance companies know that many patients may avoid dental visits and will have multiple problem areas. While an emphasis on routine care is important, we can also focus on scheduling your treatment into more manageable phases to minimize the cost impact and maximize your insurance benefits. If you have any insurance-related questions, please do not hesitate to call us. Our team is highly skilled in helping answer any questions about the best insurance for your needs.