Individual Dental Insurance Plans Secrets & Tips

Everyone knows that, just like other health care costs, dental care costs are on the rise. The sad thing is that most of the population in the United States is without Dental Care insurance and most of those that do have individual dental insurance plans get it through their health providers.

When you are looking to buy dental insurance through your company or individually there are some things you need to consider before buying. Deciding on dental insurance is not easy, especially when you are looking at so many quotes and figures.

The Three Types of Individual Dental Coverage

The first type of dental coverage is Preventive Care. Most insurance companies will cover exams and cleanings when it comes to preventive care. Some companies will even cover X-rays, sealants and fluoride treatments under preventive care.

The second type of dental coverage is Basic and Restorative Care. Here is a list of what most insurance companies consider as basic care: fillings, simple extractions and root canals. All the fun stuff!

The third type of dental coverage is Major Care. Here is what most insurance companies will consider to be major procedures: surgical extractions, partials, dentures, bridges, crowns and implants.

Because all insurance carriers are different, when it comes to individual dental insurance plans you should always be sure of what procedures fall under which categories. Some insurance carriers won't cover major procedures and some have long waiting periods before the procedure can be done.

The Network

Just like health insurance, many individual dental plan providers have a network of dentists that they allow you to see and still cover procedures. Before buying you should find out if your potential providers have specific dentists that they are contracted with. If they only allow you to see dentists in their network you will need to get a list of dentists in your area and choose one.

Some plans will let you see dentists out side of their network, however as usual there is a catch. When you see an out of network dentist the insurance company will most likely lower costs and procedures they would normally cover for participating dentists. Choosing an in network dentist is usually your best choice.

Maximum Cover Per Year

Many insurance companies will have a limit amount of coverage a year that the policyholder must deal with. For most insurance companies the limit of what they will cover is $1,000 per year. The bad thing about this is, if you do not use up all of that limit the extras do not move on to the next year. It's not like carry-over minutes.

Clauses... and no, I am not talking about the ones that live in the North Pole!

There are two clauses that you need to be on the look out for when choosing your individual dental insurance plan. The first is the "missing tooth clause". Basically this clause states that if the tooth went missing before the policy's starting date the insurance does not have to pay for it.

The second clause is called the "replacement clause". This is somewhat similar to the missing tooth clause with a few differences. The clause states that if you have a partial, bridge or dentures and you loose or break them the insurance company does not have to replace them until the waiting period is up. This period varies but is usually somewhere in the neighborhood of 5 years.

Making your teeth look pretty with insurance

When it comes to individual dental plans most of the time you will find that the companies will not cover cosmetic dental work. This means that any procedure that is done for vanity purposes will most likely be covered by the patient and not the insurance company.

The Usual, Customary and Reasonable Fees

All companies that offer individual dental insurance plans use the UCR fee guide. Basically this means that each company will set a fee they will allow and cover for a specific procedure. The amount is not based on what the dentist charges but what the company wants to cover.

When you go to a dentist that participates in the network of your insurance company you should not have to pay the difference between what the company allows and what the dentist charges. When the dentist has a contract with a specific insurance provider they will usually agree to write off the extra charges. If you go to a dentist out side of the network you could end up paying the difference.

Does the waiting ever end?

Most insurance companies that provide individual dental insurance plans have waiting periods. The waiting period is the length of time between getting your insurance and when the company will begin paying for your dental work. So basically if you need a filling or an extraction and your insurance company has a year or more waiting period for those procedures, you could have paid for them yourself many times over. However, this does not mean that you shouldn't sign up anyway because if you wait two years before signing up, you're still going to have to wait another year to be covered for those procedures.

Discount Plans vs. Insurance

Individual dental insurance plans seem to be better for the patients than discount plans for many reasons. Discount plans offer limited discounts and the patient has to pay what is not covered at the time of service. Individual dental insurance plans offer a certain amount of coverage they will allow you in one year; most people do not even go over this amount.

Additionally individual dental insurance plans pay for the entire procedure, unless you have small co-pay you will not have to pay anything at the time of service. Co-pays are usually pretty small ranging from three to ten dollars per visit where as the amount not covered by discount plans can be much greater.

In the end it is only you who can decided whether or not you need or want to have a individual dental insurance plan to help you will all your dental needs. You can talk to your dentist and together your current health care insurance provider and ask about dental insurance. Together you may be able to come up with a solution to you dental costs.

Who should you turn to?

As a representative of Aflac, I can tell you that we have one of the best individual dental insurance plans around. So, if you are in the San Diego area, I can definitely help you out. Just email me or call me at 619-495-3537.

Return From Individual Dental Insurance Plans Secrets & Tips to Home Page