The COVID-19 crisis has made many people acutely aware of how important it is to have the right insurance coverage, and when the crisis is over and quarantine is lifted having good dental insurance will help you afford the dental care you need.
COVID-19 restrictions are slowly being lifted across the United States, which will make it easier to access dental care. If you’ve been putting off looking for dental insurance or if you’ve been avoiding getting dental work done because you didn’t have insurance, now is the time to figure out what type of insurance is a good fit for you.
There are several different types of dental insurance. Each one is built on a different model but emphasizes preventive care. With different pricing models and coverage options, finding the right plan for you may depend on your budget and dental health needs.
Preferred Provider Organizations
A Dental Preferred Provider Organization (DPPO), has a wide network of dentists you can visit and still receive at least partial coverage. One big advantage of PPO plans is that you can visit almost any dentist and still receive full or partial coverage for the services. But you’ll save the most money if you see a dentist who’s in the DPPO network. As long as you choose a provider that is within the network you will typically only have a small copay for an office visit and you will get discounted rates on other services. If you choose to go out of network then you may have to pay higher fees or pay the full cost of treatment yourself.
Dental Health Maintenance Organizations
Dental Health Maintenance Organizations (DHMOs) are based on the HMO model in health care. When you sign up for a DHMO plan you must pick a primary provider who will provide your dental care and you must get referrals for specialty care and choose a network approved provider for any care that your primary dentist can’t provide. One of the biggest advantages of using a DHMO is that you will normally pay less out of pocket. DHMOs have one of the lowest premium costs of any dental insurance. But, the trade-off for that low cost is that you don’t have a lot of choice when it comes to your provider and you may end up paying more out of pocket if you require specialty or emergency care.
Point of service plans may be best for people who move frequently or want absolute freedom to pick any dentist they want to see. With this type of dental insurance, there is no deductible that you must meet, however if you choose an out of network dentist you must pay the entire cost of the visit and treatment up front. The insurer will reimburse you a certain amount based on the services that were performed.
If you choose a network provider most of your out of pocket costs will be reimbursed but if you choose an out of network provider you may not get anything reimbursed, or just a small portion of what you paid.
Dental discount savings plans
Discount dental savings plans are not insurance in the traditional sense. However, they can save you money on dental care. Discount dental plans are built by a company that gets a big network of dentists to work together to offer discounts on common services and treatments. You pay an annual fee to join the discount plan and you also pay the dentist directly the entire cost of services provided by the dentist at a discounted rate negotiated between the dentist who participates in the discount plan and the referring company. Discounts can range between 10% to 60% of the normal cost depending on the service provided.1 You will pay full price if the dentist you go to does not participate in the discount plan. If you have any expensive procedures ahead, you’ll likely pay a more out-of-pocket with a dental discount plan than with dental insurance.
Selecting a dental insurance plan
There are a lot of factors to consider when buying a dental insurance plan. What is covered by each type of plan, the monthly cost of premiums, the cost of the deductible, copay fees, and many other things are all important when choosing an insurance plan that will fit your budget and your life. But now, in the uncertainty of COVID-19 it’s also important to pick a plan that allows you to choose a dentist that follows proper social distancing, offers teledentistry consultations and takes precautions to keep you and your family safe.
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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.