How to Find and Choose Family Dental Health Plans
It’s important to invest in your family’s dental care. Poor dental care has been linked to several conditions, including endocarditis, diabetes, and cardiovascular disease. Unfortunately, dental care can be quite expensive. This is why you need to find the best dental health plan for your family. There are several options for family dental insurance plans to keep everyone in your family covered. But with the number of plans available, it can be difficult to settle on one. Here are some tips for finding and choosing the best family dental health plans.
Determine Why You Need a Family Dental Health Plan
Although visiting the dentist might not be everyone’s favorite activity, another reason why people tend to avoid the dentist is the cost. This is why you need to get a plan. You can either get dental health through your employer, or you can apply on your own. It’s important to choose a plan that covers dental care for you and your family. With a plan, you can rest assured that your dental costs are covered.
This will make you less scared of dental emergencies and how to deal with them. If you have children, things like having them fall and break their teeth are not unheard of. Knowing that your dental costs are covered can also encourage you to maintain good oral health. For instance, the cost won’t be a restricting factor anymore when it comes to things like routine dental cleaning, checkups, and diagnostic X-rays. This is important when it comes to assessing the overall condition of your gums, jaws, and teeth.
A dental plan will also come in handy for catering to your family’s extensive dental care needs. This includes things like dental filling, braces, and other orthodontia. They can also help you take care of the costs of things like dentures, denture implant, bridges, and crowns. To get the most out of your plan, you need to look for a While most dental insurance plans will cover at least some of the costs of these more expensive treatments, patients will tend to be on the hook for a significant amount too. On the other hand, a lot of family dental plans cover a huge chunk of the cost of routine care treatments like exams, cleanings, and fillings.
Understand the Types of Dental Plans
To get the best out of the dental plan you choose, it’s important to first understand the different types of dental plans and what separates them. Here are some that you may be interested in learning about.
Indemnity Dental Plans
This is probably the most expensive category of family dental health plans. As a result, the plans that you find in this class are not very popular. Indemnity plans are also known as “fee-for-service plans.” this is because the money provider is specific to the type of procedure that needs to be done. Insurers use amounts set by the American Dental Association. This means that if you go to a family dentist office that charges more than the usual amount, you will have to pay the remaining balance out of pocket. Another thing to note about these policies is that the insurance companies will require that you pay the entire amount required by the dentist then you can file a claim later. The moment the claim is approved, the insurance company will then pay its portion.
Preferred Provider Organization
This is one of the most common insurance packages on the market. Dentists join a PPO network, and then they negotiate their fees with the insurance providers. This means you will benefit significantly only if you use a dentist who is part of the PPO network. If you get treatment from an out-of-network dentist, you will have to pay a significant amount out of pocket. This type of plan tends to be a bit expensive due to the administrative costs. Still, they are a bit more flexible than other plans since they come with a wider network.
Health Maintenance Organization
This plan is a lot like the previous one. You will pay monthly or yearly fees, and then you can receive treatment from dentists that are part of the network only. Sometimes you will be required to live in the area where the HMO is offered. This plan is the cheapest of the three types described.
Know What the Policy Covers
If you are looking for a dental plan for your family, you can choose from the plans described above. Before you choose a plan, it’s important to ensure that you carefully go over the terms and conditions. This will allow you to understand how the plan works and what it covers. You will also be able to budget for your dental expenses. For instance, there are PPOs that cover exams, cleanings, X-rays, and other smaller dental procedures. However, the plan may require that you wait until the second year so you can get coverage for dental implants, crowns, and gum disease treatment.
You should also understand if the plan covers the full cost. There are some that only cover 50%, and there are some with a fixed fee structure. Knowing the possible out-of-pocket costs can help you decide what type of plan to choose. If you choose a plan with more out-of-pocket costs, it means that whenever one of your family members needs major dental work, you will part with a lot of money to cover your share of the cost.
Choose Group or Individual Coverage
You can either get group or individual coverage when looking for dental insurance for your family. Here is some information on group and individual coverage so you can make a better decision.
Before you purchase a dental insurance plan, you need to find out if you qualify for group coverage. There are lots of people that get dental insurance benefits from their organizations. There are also other group coverage plans that fall under programs like the Affordable Care Act marketplace. You can also check out public programs like Medicaid and Children’s Health Insurance Program, among others. A Medicare advisor will help you better understand these programs.
Group plans are generally cheaper than purchasing dental health insurance on your own. They also tend to have better benefits. However, before you sign up for anything, you should always take the time to really look into the details of an employer-sponsored plan. This will help you decide whether the premiums are worth what you will be paying. Getting group coverage through the organization, you will be working for is usually the best way to get dental insurance for your family. However, that still doesn’t mean you should just take the plan blindly. Always check the specifics before you start your subscription.
If you are unable to get group coverage for one reason or the other, the next step should be to look into individual family dental health plans. It’s important to note that individual policies are generally more expensive than group coverage. There are also several drawbacks with this type of coverage, whether you are getting a plan for yourself or for your family. One of the most significant downsides is that the policies come with a lot of limitations. In most instances, the insured parties will need to wait a significant amount of time before major procedures are approved.
If you are planning to sign up for a plan so you can get a particular procedure done, that will probably not work with an individual dental insurance policy. Insurers are well aware that some people employ that trick, so they usually put in place a long waiting period before you can start using the policy for anything significant.
The waiting period can last for anywhere between six months to a year, depending on the type of procedure. It’s possible to find individual plans that don’t come with a waiting period. However, these usually cost more. Before you make any decision, it’s important to make a comparison. Get lots of price quotes and policy details from various providers so you can sit down and compare. You can also sit with a knowledgeable insurance agent and they can help you go over different policies.
Find Out Which Dentists Are in Your Network
If you are already working with a particular dentist, it might also be a good idea to find out which types of family dental health plans they accept before you go in search of a family plan. As we have already discussed, an indemnity plan allows you to visit a dentist of your choosing, unlike PPO and HMO plans that restrict your choice of dentists to those in their network. If you don’t mind switching over to a new dentist, an HMO or PPO plan might better suit your needs.
Still, you need to be careful. There are chances that a new dentist you will visit can recommend lots of work that you don’t even need. There have been reports of in-network dentists recommending unnecessary procedures so they can make more money and get reimbursement for the low rates that they are given by insurers. If you are unsure which in-network dentist to trust, ask your other healthcare providers if they know a trustworthy dentist you can work with. Once you get a recommendation, you can then check what insurance policy they accept.
Will It Be There When You Need It?
Getting a dental insurance plan is not just for formalities. This is why you need to ensure that you get a plan that will be there for you when you need it. For instance, if you are going through a rough patch with your dental health, your dentist can tell you that you need to have about three procedures. Apart from that, you may also need to get regular preventative treatments, including cleanings and regular exams. So will your policy be able to cover all that?
Unfortunately, your dental insurance package may not be as helpful as you think. Have you heard of annual maximums? There are some dental plans that come with very low annual maximums. For instance, the insurance coverage may be limited to $1,000. Once your bills go beyond the set maximum, you will be stuck paying the balance on your own. The insurance company will not pay anything that exceeds $1,000 in treatment.
Apart from being limited by annual maximums, you also need to look into the co-insurance costs. Most insurance companies don’t require that you pay anything when you are getting preventative treatments. However, when it comes to more complicated procedures such as root canals, extractions, and implants, you may be required to pay 20%. Some procedures can have co-insurance costs of up to 50%. It’s important to find out what the co-insurance structure is on a policy before you sign up.
What’s Not Covered
When looking for family dental health plans, you also need to find out what they don’t cover. There are some policies that will not cover expensive procedures like orthodontics, teeth whitening, and other forms of cosmetic dentistry. Even when the policy covers them, the annual maximum will come into play, and you won’t save a lot. All these things need to be considered when you are getting a dental insurance plan for your family.
It’s important to take your time when looking for family dental health plans. You need to understand everything about the policy so you won’t get disappointed and inconvenienced later. If you find a good policy, you will get to enjoy the massive benefits. One of the advantages of getting a dental insurance plan for your family is that you will be able to access preventive care treatments like checkups, dental X-rays, and cleanings. Studies show that children that have a dental plan are more likely to visit a pediatric dentist than those without. This means if you manage to get the best plan for your family, you will be able to experience great overall health.
Just by having family dental health plans, you will feel more motivated to get preventative treatments and even more expensive procedures. One thing you need to keep in mind when purchasing insurance is that a lot of major procedures may not be covered for the initial 12 months. And even after the waiting period is over, some dental plans will only cover 50% of the cost of treatment. This means you may need to have your own money set aside to top up what family dental health plans will not cover.