Like so many other things in life, the answer is, “it depends.” Dental insurance was not standardized under the Affordable Care Act (Obamacare), so unlike health insurance, there are no essential benefits that all plans must provide, nor are there limits on waiting periods or annual maximums. Many plans are not at all worth the money for many people. If you find the right plan for your family, though, it can potentially be worth the money.
Dental insurance divides care into three types: preventive (designed to prevent problems), basic (simple dental services), and major (more complicated dental services). Most plans cover preventive care right away at 80 to 100%. Basic care and major care, though, may have long waiting periods, be covered at lower percentages and often apply an annual deductible.
Orthodontic coverage can vary greatly by plan. If a plan has Orthodontic coverage it is typically a separate life-time max from the other dental benefits. It is common for plans to limit coverage to children. Lucky patients may have coverage for all ages, but that is uncommon.
Dental implants are often handled differently by different plans. Some exclude them or cover them only under certain conditions. Most treat them as major care, while others have separate waiting periods or missing tooth clauses and coverage limits specifically for implants. Some plans may pay for the crown on the implant, but not the actual implant.
The annual cap is the maximum the insurer will pay each year, and is commonly limited to $1000 or $1500 per person. Most plans have an annual deductible on basic and major services. Unless your family is blessed with perfect teeth, a higher annual cap is generally preferable.
Another detail that varies widely is the type of plan, such as HMO or PPO, which can affect your copay amount when you visit the dentist. In addition, some plans pay the dentist directly, while others require you to pay the entire bill and then file for reimbursement. There may also be limits on how often you can have certain procedures done, even if the dentist advises you otherwise.
Dental insurance that is worth the money does exist, but you must do your due diligence. Be sure to check waiting periods and network coverage before committing to a plan.
Conveniently located in Woodbury, MN, Creekview Dental provides a progressive yet conservative approach to dental care. Our innovative, highly personalized procedures are focused on maintaining tooth structure and providing you with the healthy, beautiful smile you deserve. Call us today at 651-738-8204 to take the first steps on the road to better dental health.