dental insurance

An overview of the working of Dental Insurances

Dental insurance is most essential as it protects you from large dental bills. Dental costs today may soar endlessly given the latest technologies that are being used in dental procedures today. Hence the insurance is a safety net that must definitely be added to your yearly expenses! Almost a half of the Americans who do not pay regular (twice yearly) visits to the dentist are actually retarded by the extent of dental expenses nowadays.

This article aims to explain to you in details that the range and variety of dental insurances are wide both in terms of costs and benefits. In order to choose from this wide range, one needs to have a clear notion of the different types and levels of insurance facilities provided by different insurance providers across your region.

1. To-dos while choosing your Insurance Plan

The favorable insurance plan for you is determined to depend upon a number of factors apart from your budget. A checklist of parameters would rightly guide you to choose the insurance plan that suits you the best. The checklist is like:

2. FAQs for buying new insurance plans

If you are buying a new insurance plan for yourself or your family, or you are planning to switch from your current plan, these are some of the questions that might occur to you and you would certainly call the customer service providers to get your queries solved. Some of the most important concerns are:

  • Which drugs for my particular disease is covered under the particular plan?
  • What are the procedures of availing my insurance when travelling abroad?
  • How to get this plan for myself, like what are the documents required?

3. Different types of Insurance Plans: a list

The primary job that remains to be done before making a choice is, understanding the difference between the various types of dental insurance plans available:

  • HMO: Health Maintenance Organization
  • PPO: Preferred Provider Organization
  • EPO: Exclusive Provider Organization
  • POS: Point of Service Plan 

You want lower out-of-pocket costs and one particular doctor that planning your medical care for you, including ordering tests and coordinating with your specialists, you should opt for a HMO. If you prefer to go for more provider options and don’t much require referrals, go for a PPO. On the other hand, a lesser out-of-the-pocket cost with no required referrals is ensured by an EPO.

4. Dental Insurance Plans: HMO, PPO & Indemnity Plan

Dental Insurance Plans are a bit less complicated. Primarily they fall under any one of the 3 categories:

  • The HMO network where you are to use an in-network dentist and only then the plan pays
  • The PPO network where a non-network dentist may be chosen but larger amounts need to be paid out-of-the-pocket
  • An indemnity plan – you can walk in to any dental office but you need to pay on your own, submit a claim and wait for the reimbursement.

Dental PPO plans are the most common ones. They generally have initial deductibles such as $50 or $100, which is the amount you must pay the dentist before the plan pays for further treatments. The plan then pays for a percentage of the total dental care, the most common one being the 100-80-50 pattern which goes like:

  • 100% coverage for preventive cleanings and care.
  • 80% for the common procedures such as cavity fillings.
  • 50% of the major work such as bridges and extractions.

5. Other types of Dental Insurances

5.1 Group dental insurance

Americans who get private dental insurance for themselves, 92% get it working through another group. This is advantageous for the employers too. They get a group rate and often pay a portion of workers’ dental insurance premiums. This makes group dental insurance the lowest cost of dental coverage!

5.2 Individual Dental Insurance via insurance brokers or online buying

For those numerous Americans whose employers don’t pay for their dental plans, private individual dental insurance plans are available. They can be purchased through the dental plan websites or some insurance brokers. They usually cost around $20 to $60 per month per family member and therefore do not prove to be too much for your pocket.

However, individual dental insurance plans have certain strict terms and conditions like:

  • They are a 12-month minimum contract.
  • They include a 6 to 18 months’ waiting period before they pay for any serious or expensive procedures.

These rules are specially made to discourage people from buying insurance only when they are in need of it or prevent them from canceling the plan once a large bill is paid!

5.3 Savings Plans by your dental office

Finally, there are some people who could end up at a particular dental office with no insurance plans at hand! Generally, each dental office has its own savings plan, which is specifically designed keeping the needs of their patients in mind. When you are at Promenade Centre for Dentistry, from the unique savings plan of your dental office, you can avail benefits like:

  • twice yearly dental cleanings (in absence of gum disease),
  • 1 Comprehensive Exam per year
  • 1 Emergency Exam per year
  • Fluoride treatments and X-rays

The number of benefits availed depends upon which slab of Membership Fees you are choosing to pay for. Accordingly, you can do the following:

  • Choose your number of family members to be included within the plan
  • Choose the type of premium payment you want to go for
  • Avail special discounts in services like: Fillings, Root Canals, Crowns, Veneers, Dentures or Invisalign

Visit our Dental Saving Plan page and learn more about dental insurance and saving plan provided by Promenade Center for Dentistry.

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