Four things everyone should know about dental insurance
“Which dental insurance should I look into?”
This is a question we hear all the time. Your dentist has recommended dental implants and once you realize they cost more than having a cavity filled, your mind goes to the obvious place: dental insurance. A quick search will return dozens of results – how do you know which coverage is right for you?
Here are four things you need to know about when choosing dental insurance.
- Dental insurance is vastly different than medical insurance. People are often surprised that their out-of-pocket expenses end up being more for routine dentistry than a knee surgery, even though they have dental insurance. “I was in the hospital for a week and never received a bill.” It is important that you look at dental insurance through a different lens than you are used to with medical insurance. They are vastly different.
- Maximum coverage is the ceiling of their participation. The average dental insurance has a maximum annual allowance of $1,500 - $3,000. Unless you are part of a labor union or similar, the average dental plan has a maximum of either $1,500, $2,000, $2,500 or $3,000. The maximum coverage means just that: they will pay only that maximum per calendar year, and not a penny more; you are responsible for the rest.
- Maximum coverage is not a guarantee of coverage for all procedures. This is where a lot of people feel the sting. We get the feeling that our insurance maximum of, say, $2,000 is like cash in hand and we won’t have any out-of-pocket dental expenses until that’s been used up. That’s not the case at all. Here’s an example: if John Smith sees a dentist for a tooth extraction and a dental implant, it is very possible and all too common that his particular insurance plan will cover 50% of the cost of the extraction and none of the dental implant (or vice versa). That means he is responsible for the other 50% of the tooth extraction and 100% of the dental implant, even if he has money from his maximum coverage remaining. Familiarize yourself with the coverage percentages of different dental procedures before finalizing on a plan.
- Dental insurance is not a predictor of good treatment. Selecting a dental provider simply based on whether or not they are contracted with your dental insurance can be dicey. Because dental insurance companies are for-profit and generally pay very little for services rendered, putting your dental insurance in the driver’s seat of your oral health decisions is putting your fate in the hands of number crunchers who have their own best interest at heart. Make sure you select a dental provider who is reputable and focused on what is the best for their patients, not one who is driven by dental insurance. The bottom line: Dental insurance should be a consideration, not a driving factor.