Dental Plan Overview

Dental Health Important for Overall Well Being

Dental health is an important component of your well being. Since many medical conditions can be caused and/or aggravated by poor dental hygiene, preventive care is essential. Dental insurance is modestly priced and offers the convenience of no cost preventive exams each year.

Also, if you are enrolled in a Medicare Supplement plan, there is no dental coverage included with the policy.

Shop for Dental Plans in Your Area

You can shop online for plans in your area and enroll yourself. Click here and you will be directed to another page on our website with links to dental insurance companies to review your options and enroll online, if you choose.

Have questions before enrolling? Just call the number above and we will walk you through your options.

Learn About Dental Plans

Types of Dental Plans

When selecting any dental plan, there are different plan types and coverage categories within each plan to evaluate and whether there are provider networks that you must use, if available. As with other health care coverage, the greater the flexibility, the greater the monthly premium cost.

Examples of such plan types include the following:

• Dental Maintenance Organization (DMO): Offers a narrow network of dentists and specialists you must use for services. Premiums tend to be lower for this plan type.
• Preferred Provider Organization (PPO): Offers a wider network of dental providers you may use for services and the flexibility to use providers that may be out of network which may require a higher cost share.
• Indemnity Dental Plan: May offer a broader selection of dental care providers than other plan types. Usually, the carrier pays for covered services only after it receives a copy of the invoice after you receive services, which means that you may have to pay up front and then obtain reimbursement from your insurance carrier. 
• Discount Dental Plan: Low cost or no cost options that entitle you to a discount off the participating providers standard fees. Some plans may include a discount card for dental services not typically covered by a policy (i.e. veneers).

Common Components of Dental Insurance Coverage 

While coverage differs from one insurance company to another, there are common elements to every dental plan. As always, read the fine print of your policy or agreement to find out what and how your dental plan covers all services.

• Annual Deductible: May require each insured person to pay an initial deductible amount before the plan begins sharing the cost. Most policies are commonly capped at $150 per year per family. In addition, preventive exams may not be subject to the deductible.
• Annual Maximum: This value represents the maximum amount of expenses the plan will pay on behalf of any one person on the policy during any 12 month period.
• Preventive Services: These services are usually available as of the effective date of coverage and includes the following.
  • Evaluation and examination (usually 2 per year)
  • Teeth cleaning
  • Fluoride treatment
  • X-rays (bitewing/full-mouth)
• Basic/Minor Restorative Services: These services are usually available as of the effective date of coverage and includes the following.
  • Amalgam and resin-based composite fillings
  • Simple extractions
  • Emergency treatment of dental pain
  • Consultations
• Major Restorative Services: These dental services may have a waiting period and/or cost share limitations initially. Its important to understand how such features impact coverage during the first few years of the plan.
  
  • Deep sedation/general anesthesia for major services
  • Crown services
  • Oral surgery
  • Periodontics
  • Endodontics
  • Dentures
  • Implants
• Orthodontic Coverage: May include coverage for braces and other orthodontic services up to a lifetime maximum. Some plans limit care to individuals up to age 19 whereas others have coverage available for all ages.

Question: Why do plans have a waiting period and/or increase the cost share over multiple years?

Answer: These elements are put into place to avoid someone enrolling in the plan, receiving services, and then canceling. Having these elements within a plan helps to maintain modest premiums for all individuals enrolling in coverage.

This is a brief overview of the coverage that can be included in a dental insurance policy. You should read the policy thoroughly before purchasing coverage.