Dental health is essential to promoting overall health in the body. Dental care requires regular dental exams and cleanings and promptly addressing any dental concerns that arise. Unfortunately, dental services can be costly. Having dental insurance coverage can help individuals maintain dental well-being and alleviate the financial burden of dental care.
Dental Insurance Glossary
Dental insurance is a type of insurance that can help cover the costs of dental care and procedures. Having dental insurance can help alleviate the financial burden of costly dental care services. Dental insurance plans typically cover routine preventive services, such as check-ups, exams and cleanings, as well as basic and major dental procedures.
Cost Savings: Dental care can be expensive, especially when it comes to more comprehensive dental procedures. Having dental insurance can help you save hundreds and even thousands of dollars on covered dental services.
Promotes Dental Health: If you have dental insurance, you are more likely to schedule and follow through with preventive care. Routine dental services, including exams and cleanings, help identify and treat oral health concerns before they become more significant and costly issues.
Financial Protection: Unexpected dental services can be exceptionally expensive. By having dental insurance, you can have some peace of mind with the financial protection it provides when unforeseen dental issues arise.
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Dental insurance plans typically cover preventive services, such as routine check-ups, exams and cleanings. Most plans will cover two preventive visits a year, although some may cover additional. Dental insurance plans may also cover basic and major dental procedures, including fillings, extractions, crowns, and root canals. Some dental insurance plans may even cover a portion of orthodontics and prosthodontics, such as implants, bridges and dentures. Many options are available for dental coverage, and what is ideal for you will depend on numerous factors. It’s important to note that dental insurance plans may have limitations, such as waiting periods and annual maximums. There may also be some procedures that are excluded. When selecting your dental plan, you’ll need to carefully review the coverage details to ensure it provides the benefits you are looking for.
The types of dental services covered by dental insurance will vary from insurance company and policy. What is covered under each category, the percent it is covered at and the limitation of how much is covered will be unique to each plan. Here is a general guideline of the different types of dental services and how dental insurance plans may cover them.
Preventive dental services such as routine exams, cleanings, checkups, x-rays. These services are typically covered up to 80-100%, with no waiting periods.
Basic dental services such as fillings and extractions. Most dental plans will cover basic services up to 50-70%. There may be waiting periods, and the covered amount will be subject to plan annual maximums.
Major dental services include crowns, implants, wisdom teeth removal, complex extractions, oral surgery, and dentures. Some dental insurance plans may exclude these services. Plans that cover major restorative dental services generally provide coverage up to 20-50%. There may be waiting periods, and the covered amount will be subject to plan annual maximums.
Some standard exclusions with dental plans include cosmetic procedures and pre-existing conditions.
Discount Plan
A dental discount plan is not a true dental insurance policy and operates more as a type of membership. The membership provides members savings on dental services. Instead of paying monthly premiums like you would with traditional dental insurance, enrollees pay an annual fee upfront. After joining, members receive a discount card and to receive a discount, you’ll need to go to a select network of participating dental clinics. Discounts vary depending on the selected plan, dental location and services needed. Discount plans differ from traditional dental insurance; although they can provide some cost savings, they are not the same as dental insurance and may not be the right choice for everyone.
‘In-House’ Dental Plan
Many dental clinics will offer an in-house dental program to clients. This type of plan is also not to be considered a dental insurance policy. ‘In-House’ dental plans can help those who do not have dental insurance coverage. How it works: for a predetermined dollar amount, you can expect 1-2 cleanings, exams and possibly x-rays in a calendar year. The dental office may also provide other benefits, such as one emergency visit or a percentage from non-preventive services needed.
Stand-Alone Dental Plans
A stand-alone dental plan is a dental insurance policy you acquire from an insurance company that provides coverage plans in your area. A stand-alone dental plan can be purchased separately from other coverage, such as health insurance. This type of dental insurance can cover individuals, couples, or families. Stand-alone dental plans are available from many insurance companies, and they can provide a wide array of coverage options, varying from preventive-only coverage to more robust and comprehensive benefits.
Embedded Dental Plans
Some types of dental insurance may be embedded or part of another plan. This can be the case for individual, family, or group health insurance as well as many Medicare Advantage plans (MA/MAPDs). The benefits of embedded dental insurance can vary significantly from plan to plan. Some provide preventative care only, while others have more comprehensive coverage, or there may be an annual allowance for dental services.
What is the premium of the plan?
Does the plan have waiting periods?
Does the plan cover periodontal cleanings?
How much coverage is provided for major restorative work, such as crowns and implants?
Is your current dentist in the dental network covered by the plan?
At Twin City Underwriters we work with several different dental insurance companies to provide you with options. Having a plan in place for basic services like cleanings and exams, as well as more extensive services such as fillings and crowns, will provide you with peace of mind if and when these events occur.
At Twin City Underwriters, our licensed agents help you determine the ideal plan for your individual needs. All dental insurance plans offer different benefits, levels of coverage and utilize unique networks; with this in mind we work with you to ensure the plan you choose provides suitable coverage. For more information or to get a quote give us a call at 651-488-0172 or email us at info@tcunderwriters.com.
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