How Does Dental Insurance WorkLos Angeles, CA

What to Look for in a Dental Insurance Plan

There are several options available for dental insurance, catering to a variety of needs. As such, types of coverage, deductibles, and premiums vary accordingly. To help narrow down their options, patients should first determine what plans are available in their area. Certain dental insurance companies only offer coverage to certain states, so begin by ruling out any impossibilities.

Next, patients should look for a plan that covers several dentists and dental practices – whether they have a preferred provider and practice or not. It is always best to have more options. Additionally, patients should consider all costs – including the monthly premium, deductible, and any co-pays they may have to pay. It is also important to note the annual maximum and what types of procedures are covered.

Purchasing Dental Insurance

Purchasing dental is a personal issue and depends on how much dental work the patient needs and how many family members they have. Generally, the more dental work required and the more family members, the more value for the month.

The typical dental insurance plan covers preventive care: checkups and cleanings at 100% (no deductible), basic procedures (e.g., fillings and extractions) at 70%, and major procedures (e.g., crowns, bridges, and root canals) at 50%. Some procedures may be considered basic by one carrier and major by another, so patients must speak with their insurance carrier before getting dental treatments to understand the breakdown of costs and coverage.

Like health insurance plans, dental plans typically have a deductible — the amount one has to pay out of pocket each year before the plan starts to cover its portion of costs. Most plans cap the total amount they will pay for care per plan member per year. Any dental expenses over the plan's cap (or maximum) become the patient's responsibility.

Individual vs. Family Dental Insurance

While some patients only need coverage for themselves, others may require coverage for the entire family. Both individual and family dental insurance plans can be purchased through the U.S. government's Marketplace or directly through a carrier. However, premiums for individual plans are typically lower than for family plans, as they involve only one individual.

In contrast, family dental insurance plans generally have higher premiums. However, most allow for two annual exams per plan member. It is essential for patients to find the right type of coverage for them – and, if applicable, their families – that still remains affordable.

Choosing Dental Insurance

Purchasing dental insurance can be an overwhelming experience. Luckily for many people, the plan offered by their employer or professional association is the best possible option. Still, in many cases, it may be useful for patients to talk to their dentists to see what plans they accept.

Many dental offices can recommend affordable plans that cover their patients' needs. Patients should look for a policy with a high spending cap if they know they will need major work done, while patients who require less work done can look for a policy with a lower spending cap.