Maybe your employer provides health insurance — but not dental coverage. If so, you may wonder how to get your own dental insurance coverage. After all, preventive dental care can go a long way toward protecting your overall health.
Fortunately, it’s possible to purchase individual dental insurance plans for yourself and your family. Even better, you don’t have to wait for an enrollment window or qualifying event to sign up. The key is doing your homework.
“As a dentist, I see a lot of patients who don’t know exactly what they have in terms of their dental insurance benefits and coverage,” said Dr. Min Jin Kim, chief of pediatric dental services at Jersey City Medical Center.
Here’s where to start:
Know your needs
First, take stock of the kind of dental care you need now, and what you’ve tended to need in the past. “You’ll buy a different plan if all you need are routine checkup exams and cleanings than if you expect to need a lot of treatment in the coming year,” Kim said. “You want to sign up for a plan that has good coverage for the type of dental work you’ll be getting.”
If it’s been some time since your last exam and you suspect you might need some major work, you may want to get a little more coverage than if you’re already in good dental health. There are generally three levels of dental insurance plans:
• Preventive care. This level usually includes exams, basic health screenings, cleanings and X-rays.
• Basic services. These usually include fillings and routine tooth extractions.
• Major services. This level often includes root canals, bridges and crowns, and oral surgery.
Review the types of dental insurance plans
Individual dental insurance plans come in several models. The types of dental insurance plans include:
• Preferred provider organizations. These plans provide coverage for a network of dentists who agree to provide discounted rates for their services. Preventive services are usually completely covered, and you may need to pay a percentage of basic or major services. There’s also often an annual maximum and an annual deductible.
• Fee schedule plans. Under these plans, covered services are paid for at a specific reimbursement rate, whether you see a dentist who is in a network or not. These plans also have annual maximums and deductibles.
• Cleaning-only plans. These bare-bones plans pay only for an annual tooth cleaning and exam, but may come bundled with other services or coverage, such as vision insurance.
Compare options
No matter which type of dental insurance plan you pick, you’ll want to get one that’s the best fit for you. And each dental insurance plan will have different conditions and features to consider. Some of these variables may include:
• Network availability. “If you already know your dentist, consider signing up for a plan with a network the dentist is in to maximize your benefits,” Kim said. A quick call can help you determine how a dental insurance plan will cover out-of-network services. Some insurance carriers will invite your dentist to join their networks if you request it.
• Customer service. Speaking of a quick call, you’ll want to find a dental insurance plan with a strong approach to customer service. Whether it’s a call center ready to answer your questions or online resources, customer service can be a make-or-break for the dental insurance plan you pick.
• Cost estimates. When you’re getting dental work done, it can be tricky to determine actual costs until after the bill comes. Some dental insurance plans will let you check before you get the work done to get an estimate of how much of a procedure will be covered. And most dentists will work closely with you to get the full benefits and coverage allowed, Kim said.
• Waiting periods. Some dental insurance plans require waiting periods for certain levels of service, especially major services, before you can access your benefits, while others are available almost immediately.
This post is based on content that first appeared in SmileInSight by Starmount.
