Dental Insurance: Understanding the Basics

For many people, dental care can be incredibly expensive. This is especially true for those without dental insurance. In fact, a study by the National Association of Dental Plans found that individuals without dental coverage are more likely to have to forego necessary dental care due to cost. If you are considering investing in dental insurance, this article will provide you with a comprehensive guide to help you better understand it.

What is Dental Insurance?

Dental insurance is a type of health insurance that is specifically designed to help you pay for dental care. In exchange for paying a monthly fee, known as a premium, dental insurance will help cover the cost of routine dental procedures, such as check-ups, fillings, and cleanings. Some plans may also cover more expensive procedures, such as root canals or orthodontic treatment.

It is important to note that dental insurance is different from medical insurance. While medical insurance helps pay for doctor and hospital visits, dental insurance is designed to specifically help you pay for dental care.

How Does Dental Insurance Work?

Like other forms of insurance, dental insurance works by pooling the premiums paid by many different people. This money is then used to pay for dental procedures as needed. Depending on your plan, you may be required to pay a certain amount out-of-pocket before your insurance kicks in.

Typically, dental insurance plans will cover a certain percentage of the cost of a dental procedure. For example, your plan may cover 80% of the cost of a filling, leaving you responsible for the remaining 20%.

What Types of Dental Insurance Plans are Available?

There are a variety of different dental insurance plans available, but they generally fall into two categories: indemnity plans and managed care plans.

Indemnity Plans

Indemnity plans are also known as traditional plans. With this type of plan, you can visit any dentist you choose, and your insurance will cover a set percentage of the cost of the procedure, up to a certain amount.

Indemnity plans tend to have higher premiums, but they offer more flexibility when it comes to choosing a dentist.

Managed Care Plans

Managed care plans are more common than indemnity plans. With a managed care plan, you typically choose a dentist from a list of participating providers. These dentists have agreed to provide services at a reduced rate to patients with this specific type of insurance.

Depending on the type of managed care plan you choose, you may be required to choose a dentist from within a specific network.

What Does Dental Insurance Cover?

While what is covered under your dental insurance plan can vary, most plans will cover preventive care, such as cleanings and check-ups. Many plans will also cover basic procedures, such as fillings or extractions.

More complex procedures, such as root canals, crowns, or orthodontic treatment, may only be partially covered or not covered at all, depending on the type of plan you have.

What Are Common Terms Used in Dental Insurance Policies?

When considering a dental insurance plan, there are a number of common terms you should be aware of. These include:

Term
Definition
Premium
The amount you pay each month for your dental insurance plan.
Deductible
The amount you will need to pay out-of-pocket before your dental insurance begins to cover a portion of your dental expenses.
Coinsurance
The percentage of the cost of a dental procedure that you are responsible for paying.
Maximum Annual Benefit
The most your insurance plan will pay for dental care within a given year.
Exclusions
Services or procedures that are not covered by your dental insurance plan.

What Are Some Common FAQs About Dental Insurance?

Do I Need Dental Insurance?

While dental insurance is not a requirement, it can help you save money on routine dental procedures. If you visit the dentist regularly, getting dental insurance may be a smart choice.

Can I Buy Dental Insurance on My Own?

Yes, you can buy dental insurance on your own. You may be able to get it through your employer or purchase it through a private insurance provider.

Is Dental Insurance Worth the Cost?

Whether or not dental insurance is worth the cost will depend on your individual dental needs and how often you visit the dentist. If you need frequent dental procedures, dental insurance can be a smart investment. However, if you only visit the dentist once a year for a check-up, you may be better off paying for the check-up out-of-pocket.

What if I Need a Procedure That Is Not Covered by My Dental Insurance?

If you need a procedure that is not covered by your dental insurance, you will be responsible for paying for it out-of-pocket. Some dentists may offer payment plans to help you cover the cost of a procedure over time.

What Happens If I Don’t Have Dental Insurance?

If you don’t have dental insurance, you will be responsible for paying for all of your dental expenses out-of-pocket. This can be incredibly expensive, and may result in some people avoiding necessary dental procedures due to cost.

Conclusion

Dental insurance can be a smart investment for those looking to save money on routine dental procedures. When considering a dental insurance plan, it is important to understand the different types of plans available, as well as what is covered under your plan. By making an informed decision about your dental insurance, you can ensure that you receive the dental care you need without breaking the bank.