Did you know that according to a 2018 study, more than 31% of all adults in the U.S. have untreated dental decay or other serious dental problems?¹ Considering that more than 37 million adults don’t have dental insurance that’s probably not much of a surprise.² However, adults who don’t have dental insurance or don’t want to pay high premiums to get dental insurance through an employer might have another option. Private dental insurance is available to help you and your family have healthy teeth.
Affordable coverage with no waiting period
Comprehensive dental insurance isn’t as expensive as many people may think. Private dental insurance is similar in some ways to medical insurance, but typically it doesn’t come with the high premium costs that people typically expect to pay when they are buying medical insurance. Affordable coverage plans will typically pay for preventive services so that you can help prevent serious dental problems. Some dental insurance may not have waiting periods, which means that you don’t need to wait for months to get the dental care that you need.
Every dental insurance plan is different. You may be able to customize your coverage by selecting an affordable dental care plan that provides the type of coverage that works for you and your family. But typically, dental insurance with no waiting period may cover the total cost of any preventative services such as X-rays, oral exams, and cleanings. A full set of dental X-rays may be expensive, but the dentist needs to see them in order to be able to work up a treatment plan that is right for you. Subject to your plan’s annual maximum, because they’re essential for dental care, your dental insurance should cover their cost or a portion thereof. Other preventative services that almost every dental insurance plan will pay for include:
Cleanings every six months
Dental checkups and appointments
Fluoride and sealant treatments for children
Additional services like extractions, fillings, and crowns may not be covered fully but depending on your plan and your insurance carrier, you can get an affordable price on those necessary services. Emergency dental services are also usually covered with no deductible or waiting period when you sign up for a dental insurance plan so you’ll have the confidence of knowing you are protected by dental insurance.
PPO dental insurance
PPO dental insurance plans give you the choice of going to a dentist that you feel comfortable with. PPO insurance companies typically have a nationwide network of dentists. When you see a dentist that is in the network you can save money on your dental cost needs.
Maximums and limits
Most dental insurance companies have a maximum benefit amount that they will pay per year, so it’s important to know what the maximum is for any plan that you’re considering. Generally, preventative services like cleanings or oral exams and some procedures like fillings or extractions may not count towards the annual maximum. However, every plan is different so when you’re shopping for dental insurance plans the maximum paid by each plan is something that you should be aware of. Typically, plans with higher maximums will have higher premiums.
Affordable dental insurance plans
What does “affordable” mean when it comes to dental insurance? Everyone’s definition of affordable is different, but when it comes to choosing a dental insurance plan affordable means finding a plan that offers good value for the money that you pay. There are three common factors that typically go into determining the affordability of a dental insurance plan: the premium, the deductible, and the maximum amount of the benefit per year.
The cost of the premium shouldn’t make it difficult for you to pay each month for the dental care you need. But, sometimes it may be worth paying a little bit more for the premium cost in order to get a plan with a low deductible or no deductible. If your deductible is high typically you will need to pay out of pocket before your insurance starts to pay for the care that you need. You need to consider the maximum benefit offered by the plan also because you will likely be stuck paying out of pocket for any costs that are over the maximum benefit per year.
Shopping for dental insurance can feel daunting because you really need to pay attention to the fine print and the coverage options that are available. However, by taking the time to look at the coverage offered by each plan you ultimately can save money on dental care cost and make sure that you get the dental care you need.
When you’re comparing the coverage options of various insurance plans make sure that you look at whether or not preventative care is covered when you’re considering a particular plan. Preventative care typically will not count against your maximum benefit so you can get the preventative care and service you need usually at an affordable cost.
If you need to have some serious dental work done, including oral surgery, you may be able to get your medical insurance to pay for those procedures. If a dental or oral health treatment is necessary to treat or to prevent a physical health problem, then your medical insurance may pay for that treatment.
A smart thing to do when you’re choosing a dental insurance plan is to think about the amount of dental care that you’re going to need in the next year before you buy a plan. If you have pretty good dental health finding a plan with a lower maximum and lower premium costs that help cover the cost of preventative treatments might be a good fit. But if you know that you need several crowns, a root canal, or other serious dental work you would be better off choosing a plan with the highest possible maximum benefit.
Are there no maximum dental insurance plans?
Unfortunately, no dental insurance plan is going to cover the total cost of everything. When you’re looking at dental insurance coverages there are three common types of plans: preventative, basic, and major.
Preventive dental insurance plans are centered on making sure that your teeth stay healthy so that you can avoid needing major dental work. If you have generally pretty good teeth and you’re really looking for a dental insurance plan that will help you stay that way a preventative plan that covers up to 100% of preventive services may be the best choice for your needs.
A basic dental insurance plan is typically designed to be easy on the wallet while still covering the most common types of dental work such as fillings. If you are buying insurance to cover your whole family a basic plan will likely give each family member access to the services they need at an affordable cost, depending on the procedure.
Major dental insurance coverage is a great fit for anyone who really just wants to be sure that if they have an accident or a dental emergency they won’t get stuck with a huge bill that they won’t be able to pay. However, coverage and costs can vary depending upon the plan level you select.
DHMOs, waiting periods, and other considerations
You should know that if you choose a DHMO dental insurance plan you usually will not get to pick your own dentist. Your plan may require you to go through your regular dentist to get a referral to a specialist or another dentist from your dentist in order for the insurance to pay any of the cost. PPO dental insurance providers don’t require a referral, but some of them do have a waiting period which typically means that you won’t be able to get dental care right away.
Yearly maximums can make it seem like dental insurance isn’t really worth the cost, but the reality is that most people typically may not get close to needing the maximum benefit each year. Dental insurance that pays for preventative and basic care at discounted rates can help save you money per year, especially if you have kids.
If you’re worried about your maximum benefit or how much you will need to pay out of pocket for dental care, it’s always a good idea to talk with your dentist about your concerns before you schedule any serious and potentially expensive procedures. Your dentist’s financial liaison may have ideas to help you pay for your cost portion of any care that’s needed.
How much is comprehensive dental insurance?
The cost of comprehensive dental insurance premiums depends on the plan that you choose as well as other factors like whether you choose a PPO or DHMO and what pre-existing conditions you have. Guardian Direct® offers three different plan choices: Bronze, Silver, and Gold so that you can find a plan that is affordable for your budget and offers the coverage* that you need.
If you’re worried about paying a high monthly premium cost preventative care plans are the lowest cost options Guardian Direct offers that can allow you to get necessary care at an affordable rate. However, if you know that you’re going to need one or more major dental procedure like a root canal, oral surgery, or dentures purchasing a plan that goes beyond preventive services like the Gold plan will give you the most coverage for your dental care.
Before you schedule a major procedure it’s smart to check your coverage, your co-pay, and other details of your insurance plan so that you know what portion of the cost you will be responsible for paying.
How to buy comprehensive dental insurance
Unlike medical insurance typically there is no set enrollment period for dental insurance. You can enroll in a dental insurance plan at any time during the year with guaranteed acceptance. If you want to get dental work done immediately after enrollment check to make sure there is no waiting period for treatment before you sign up. Comprehensive dental insurance plans are designed to cover a variety of dental procedures that range from basic to major so you should schedule a consultation with a dentist so that you will know what procedures you need to have done when you are choosing a dental insurance plan.
Choosing a dental insurance plan can seem overwhelming at first because there are so many options and factors to consider. Keep in mind as you browse through plan costs and coverages that bundles and dental savings plans may lower your costs for preventive care but typically do not cover much to help pay for major procedures. If you know that you are going to need major dental work, a comprehensive dental insurance plan will likely give you the coverage that you and your budget need.
* Coverage begins on the first of the month following enrollment. Dental provider networks vary by state, by market and by plan type,
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Brought to you by The Guardian Life Insurance Company of America (Guardian), New York, NY. Material discussed is meant for general illustration and/or informational purposes only and it is not to be construed as tax, legal, investment or medical advice. This is not dental care advice and should not be substituted for regular consultation with your dentist. If you have any concerns about your dental health, please contact your dentist's office.
Brought to you by The Guardian Life Insurance Company of America (Guardian), New York, NY. Material discussed is meant for general illustration and/or informational purposes only and it is not to be construed as tax, legal, investment or medical advice.(exp.12/22)