The best dental insurance typically covers preventive care, x-rays, and fillings as well as major procedures like crowns and root canals. However, it’s important to understand annual maximum coverage limits and deductibles before enrolling in any policy.
Preferred provider organization plans offer a wider network and lower copays than fee-for-service. Plans with no waiting periods earn higher scores.
1. Preventive Care
Most dental insurance plans cover preventive care, which focuses on keeping your teeth healthy and identifying potential problems before they become more serious. Preventive procedures like routine exams and cleanings are typically covered 100% by the plan, with no deductible or copayment required.
Many dental plans also cover basic procedures like extractions, fillings, and root canals. But they may not cover these services completely, and a variety of out-of-pocket costs like deductibles, copays, and coinsurance apply. Some policies also have waiting periods, which can be six to 12 months for some procedures. eHealth’s licensed insurance agents can help you understand these details and find the best dental coverage for your needs.
2. Routine Exams
Daily brushing and flossing are great, but professional care is crucial to good oral health. Dental insurance is a way to offset the costs of routine cleanings, check-ups and more extensive treatments.
Most dental insurance plans divide procedures into categories, like preventive, basic and major. Each service category has a different percentage that the plan covers, leaving the patient responsible for a portion of the cost.
Colonial Life offers a wide selection of dental plans and options. Choosing the right plan is important. You should also consider deductibles, copays and annual coverage maximums. Plans with managed-care dentist networks often offer lower rates and pre-determined copayments. These plans may come in the form of health maintenance organization (HMO) or preferred provider organization (PPO) models.
3. X-Rays
A medical and dental x-ray is a type of imaging technique that uses ionizing radiation to create images of internal structures. Because bones are denser and absorb more ionizing radiation than soft tissues, x-rays can show bone structure and indicate the presence of cavities.
Dental insurance typically covers a portion of X-ray costs. A patient can choose a plan that reimburses dentists directly for services or a traditional indemnity plan that reimburses patients based on a table of allowances. In either case, most dental plans have a deductible and caps on annual coverage. This is why it is important to shop around and compare the options available. In addition, look for a plan that offers a network of in-network dentists.
4. Fillings
Fillings are typically covered by most dental insurance, but the amount of coverage you receive varies between policies. To find a plan with the most filling coverage, look for a low-premium PPO that offers 100% preventive care, 80% of basic procedures, and 50% of major services.
As with selecting any insurance policy, it’s important to carefully examine the fine print and understand your options before making a decision. Consider factors like copays (a fixed dollar amount that may or not count toward your deductible) and coinsurance (a percentage of the remaining costs after you’ve met your deductible). You should also pay attention to the annual maximum, which is the most your plan will pay in a year for covered care.
5. Crowns
Crowns are like protective caps placed on teeth to cover damaged areas, improve appearance and enhance function. They are typically used after root canal therapy or for large fillings.
Though usually associated with molars, crowns can be placed on front teeth as well. They can also be used to restore a weak or severely discolored tooth, and may require some reshaping of the natural teeth for optimal results.
The cost of crowns varies depending on the type of material and your dental insurance provider’s network. Consider a dental savings plan to minimize out-of-pocket costs. They typically come with annual maximums and deductibles. These limits are a big factor when choosing the right insurance to fit your needs.
6. Bridges
Dental bridges are a great option for replacing missing teeth. They are comfortable, aesthetically pleasing and can improve the overall health of your smile. They can also prevent other teeth from shifting toward the empty socket and prevent jawbone deterioration.
A missing tooth can affect your speech, cause discomfort while chewing food and even lead to other dental problems such as gum disease. A bridge fills in the gap with a false tooth that looks natural and functions like a real tooth.
There are different types of bridges, including traditional and implant-supported. Each has its own benefits and risks. With proper care, your bridge will last for years to come.
7. Root Canals
Many insurance plans have a maximum amount they’ll pay in a year. Once this amount is reached, the patient must cover the remaining costs, depending on policy details.
Different types of dental plans have different coverage arrangements. For example, Health Maintenance Organizations (HMOs) often require patients to choose a primary care dentist and may have limited provider choices. Preferred Provider Organizations (PPOs) generally offer more freedom of choice but could have higher premiums.
Copayments and coinsurance are two common types of cost sharing. Typically, copayments are a flat fee per visit or treatment, while coinsurance is a percentage of the remaining cost that the enrollee must pay after the insurance company pays their portion.
8. Implants
Dental implants offer a permanent, natural-looking replacement for missing teeth. Implants are more expensive than other tooth replacement options like bridges, but they also last longer and can prevent bone loss.
Some plans cover all costs of the procedure, but many come with a yearly maximum and require a copay or deductible. The best way to find out whether your insurance policy covers dental implants is to read the coverage details carefully.
Most dental plans follow a 100/80/50 payment structure, meaning that they cover preventive services at 100%, basic procedures at 80%, and major procedures at 50% or higher. Some policies even include orthodontics, although they are usually limited to lifetime maximums and have age restrictions.
