Dental insurance plans help a lot of people to pay the cost of maintaining good oral health. Understanding dental insurance policies compared to medical insurance is a breeze. Most insurance policies are straightforward and specific when it comes to what procedures are covered.
When getting an insurance policy, you can also precisely know how much you need to pay out-of-pocket. In the same vein, dental insurance can be available as part of a medical insurance policy or as a standalone insurance plan.
However, most people avoid dental insurance due to the cost. It shouldn’t be so. Dental Insurance is not as expensive as most people think. In this blog, we will explore the cost of dental insurance and the factors that affect this pricing model.
Types of Dental Insurance Plans
Most insurance plans won’t cover some pre-existing conditions or reimburse for most major procedures completed before getting the insurance. If you are in doubt or unsure what plan to get, ask about the extent of coverage on each plan.
Remember that there’s always a possibility that you may need a dental procedure you don’t anticipate. In some cases, those specific procedures may not be covered by your chosen policy. The higher your premium plan is, the more likely you can get more coverage for extensive procedures. Mostly, your dentist will tell you which dental procedures you’re likely to need down the line. If not, you can ask about it before getting your insurance.
Below are the three types of dental insurance policies.
An Indemnity or Fee-For-Service Plans
An indemnity dental insurance plan allows you to choose a dental provider freely while your selected plan pays a percentage of the provider’s fee. This dental insurance policy is best if you have a specific dental provider you want to see or may need costly procedures.
- Pros: This plan lets you pick one option from the wide variety of dental care providers available. Also, the deductible is lower than other dental insurance plans. The yearly maximum coverage limit may be higher, as well.
- Cons: The monthly premiums that you pay tend to be higher than other plans. Also, you need to pay your share of service costs upfront.
Preferred Provider Organization (PPO) Plan
With a PPO dental insurance plan, you pay lower fees to see a certain “preferred” or in-network dentist.
- Pros: The insurance network pays more than an indemnity plan or HMO plan. You don’t need to see “in-network” dental providers. This plan works best if you don’t need major dental work right away. It’s more of being prepared in case you need it in the future.
- Cons: You will pay more if you see a provider out of the network. This plan often comes with a maximum amount that they will reimburse yearly. Another thing is, not all dental procedures can be covered. In some cases, you have a waiting period before the coverage starts to be effective.
Health Maintenance Organization (HMO) Plans
With HMO plans, you can see dental care providers in the insurance network. It works best if you don’t need any major dental procedures/treatments in the near future. Also, you have no provider preferences as long as the basic dental work is covered financially.
- Pros: Preventive services such as cleanings and X-rays are 100 percent covered, whereas basic dental procedures come with a co-pay. You may not be required to have a deductible or maximum annual limit. Plus, premium payments are most likely lower.
- Cons: Major or restorative procedures may come with less than 50 percent coverage or worse no coverage. You don’t have your choice of provider.
How Much Does Dental Insurance Cost?
The average cost of a dental insurance plan in Vaughan is $360 annually or between $15 and $50 monthly. Most dental insurance plans come with a coverage limit or a maximum annual benefit. The coverage limit is usually between $1,000 and $2,000.
The dental insurance plan cost varies considerably based on some factors like coverage, location, state and the number of employees.
Unlike a medical insurance policy, dental insurance cuts off coverage after your bills reach the maximum annual limit. Also, you may need to pay for any additional costs out of pocket.
What Does a Monthly Premium Dental Insurance Cover?
A typical dental insurance plan provides a level of coverage known as the 100/80/50 coverage.
- Preventive care such as exams, cleanings, and X-rays during an average dental checkup is 100 percent covered. Your dentists will recommend you to have cleanings twice, annually.
- Basic procedures such as extractions, fillings, and periodontal work are only 70 to 80 percent covered.
- Major dental procedures such as root canals, crowns, bridges, implants or dentures are only 50 percent covered or less.
However, there are some variations when it comes to individual plans. For example, a root canal treatment could be considered either a basic or a major dental procedure.
So is a dental insurance plan worth it? The answer is yes. If you need extensive procedures, having a dental insurance plan can help cover the substantial expenses. However, there are still chances that you’ll always be paying out of your pocket for some additional costs.
If you are looking for an insurance provider, be it a health insurance policy or dental insurance plan, you can rely on Life Insurance Direct. You can also use our online quote calculator to see what your premiums could be or speak with an insurance broker directly. Call us at 1-844-922-1392 or send us a message via firstname.lastname@example.org.