Dental Insurance in Pennsylvania: Everything You Need to Know

Dental insurance is an essential aspect of healthcare. It is a form of insurance that covers the costs of dental care. Dental insurance in Pennsylvania is no different. If you are a resident of Pennsylvania or plan to move to the state, you need to understand how dental insurance works in the state. In this article, we will discuss everything you need to know about dental insurance in Pennsylvania.

Types of Dental Insurance in Pennsylvania

There are two types of dental insurance in Pennsylvania:

1. Indemnity dental insurance: This type of insurance allows you to visit any dental care provider. You pay the dentist’s fees upfront, and then the insurance company reimburses you for a percentage of the fees. Indemnity dental insurance usually has a higher premium, but it provides maximum flexibility in choosing a dentist.
2. Managed care dental insurance: This type of insurance covers only dentists who participate in the insurance plan’s network. You pay a lower premium with managed care dental insurance, but the pool of dentists to choose from is limited.

Let’s look at each type of dental insurance in Pennsylvania in detail.

Indemnity Dental Insurance

Indemnity dental insurance is a type of plan that allows you to choose any dentist you want. It is also known as fee-for-service dental insurance. Here are some advantages and disadvantages of indemnity dental insurance.

Advantages of Indemnity Dental Insurance

1. Freedom to choose any dentist you want.
2. No restrictions on the type of dental procedures covered.
3. Lower out-of-pocket costs for preventive care.

Disadvantages of Indemnity Dental Insurance

1. Higher premiums.
2. Higher out-of-pocket costs for major dental procedures.
3. Reimbursement rates may be lower than the cost of the services provided.
4. You may have to pay for services upfront and then wait for reimbursement from the insurance company.

Managed Care Dental Insurance

Managed care dental insurance is a type of plan that limits your choice of dentists. There are two types of managed care dental insurance plans in Pennsylvania:

1. Preferred provider organization (PPO): In this plan, you can choose any dentist in the PPO network. You pay less out-of-pocket if you choose a dentist in the network.
2. Health maintenance organization (HMO): In this plan, you must choose a primary care dentist who is in the HMO network. Your primary care dentist will refer you to a specialist if necessary.

Advantages of Managed Care Dental Insurance

1. Lower premiums.
2. Lower out-of-pocket costs for preventive care.
3. No need to file claims or wait for reimbursement.

Disadvantages of Managed Care Dental Insurance

1. Less flexibility in choosing a dentist.
2. May have to pay more out-of-pocket for major dental procedures.
3. Limited coverage for out-of-network dentists.

Dental Insurance Providers in Pennsylvania

There are several dental insurance providers in Pennsylvania. Some of the most popular ones include:

• Delta Dental
• Aetna
• Cigna
• MetLife
• United Healthcare

You can visit the website of each insurance provider to get a quote and compare plans.

FAQs about Dental Insurance in Pennsylvania

Q: Is dental insurance necessary?

A: Dental insurance is not mandatory, but it is highly recommended. Dental procedures can be expensive, and dental insurance can help reduce your out-of-pocket costs.

Q: Can I still visit my current dentist with managed care dental insurance?

A: It depends on whether your dentist is in the network of the insurance plan. If your dentist is not in the network, you may have to pay more out-of-pocket or switch to a dentist in the network.

Q: What is the waiting period for dental insurance in Pennsylvania?

A: The waiting period varies depending on the insurance provider and the plan you choose. It is usually between 6 months to a year for major dental procedures.

Q: Does dental insurance cover cosmetic dentistry?

A: Cosmetic dentistry is usually not covered by dental insurance. However, some procedures such as teeth whitening may be covered if they are deemed medically necessary.

Q: Can I purchase dental insurance on my own?

A: Yes, you can purchase dental insurance on your own. You can visit the websites of insurance providers or consult with an insurance agent.

Conclusion

Dental insurance is an important aspect of healthcare. It helps reduce your out-of-pocket costs for dental procedures. In Pennsylvania, there are two types of dental insurance plans: indemnity and managed care. Indemnity dental insurance allows you to choose any dentist you want, while managed care dental insurance limits your choice of dentists. There are several dental insurance providers in Pennsylvania, including Delta Dental, Aetna, Cigna, MetLife, and United Healthcare. We hope this article has provided you with valuable information about dental insurance in Pennsylvania.