Enrolling for dental insurance can help protect you against unexpected dental expenses such as crowns or root canals. Your dental insurance coverage will also make it easier for you to keep up with regular cleanings, checkups and other preventative treatments. All of which helps identify the need for a crown or root canal before they become a costly expense. Before you decide to enroll for a dental insurance plan, lets learn about a few terms you need to familiarize yourself with to become an informed buyer.
How does dental insurance work?
Dental insurance works very similar to how Health Insurance works. A client pays an insurer a monthly premium towards a specific plan to receive coverage. The payment of the monthly premium allows the client the ability to receive regular checkups, cleanings, and Xrays. Some of which will be applied towards their dental plans insurance deductible. Once your deductible is met, the dental insurance companies will step in and pay a percentage of the overall bill for various procedures like crowns, root canals, dentures, and braces. However, there are waiting periods associated with some of the bigger procedures.
How to chose the best Dental Plan for you?
Here is a quick list of important questions to ask yourself before choosing a plan:
- How much is the monthly premium?
- How much is the deductible? After meeting the deductible, how much with the dental insurance provider pay towards my procedure?
- What is the dentist network? Will I be able to stay with my current dentist or will I need to switch?
- What is the cost to see a dentist outside of my dentist network?
- How long are the waiting periods for each dental insurance plan?
How long are the Waiting Periods for Dental Insurance?
A waiting period means that you will have to wait a specific amount of time before a dental insurance company will help you pay for certain procedures. Upon receiving dental insurance coverage, there will be a six month to one year waiting period before certain procedures will be covered. Here is a brief list of common waiting periods for a few well known procedures:
Six Month Waiting Period
1 Year Waiting Period
- Root Canals
The whole purpose for waiting periods is to detour potential clients from buying dental insurance only when they need to have dental procedures. The more expensive a dental procedure is, the longer the waiting period will be.
How does the Annual Deductible work for Dental Plans?
An annual deductible for dental insurance is the amount of money you have to pay out of pocket towards dental costs until your dental insurance company helps pay a percentage of your bill. For example: Your annual deductible is $750. Until you pay your annual deductible through office visits, X-rays, and lab tests, you will have to pay for those procedures on your own. Once your annual deductible is met, the dental insurer will start to help you by paying a certain percentage, ranging from 0%-60%, of your overall bill from your dentist.
What is my Maximum Payout Limit?
A maximum payout limit is the maximum amount of money that your dental insurer will pay to cover dental procedures in one calendar year (January 1 – December 31st). If your maximum payout limit is $1,000, once that limit is met, you will have to pay the remaining cost on your own.
Remember, before investing in a dental plan, make sure to ask yourself or your broker the questions above. It is imperative for you to understand this now or you may be at risk of paying more for dental procedures.
If you have any questions, feel free to reach out to us at 510-490-7700. We will be glad to answer any questions that you have.