It’s that time of year again, the opportunity to renew, change, add, or upgrade your insurance. If you are a person who purchases insurance on the individual market, dental plan options will be somewhat limited. In most cases, individual dental plans outside of employer-based plans are not worth getting. If you are stable and only need routine cleanings and exams, paying out of pocket could be your best bet, and most offices will be happy to work with you. Those patients concerned about the unexpected can open a health account paid into (instead of monthly premium) for unforeseen dental circumstances. People who understand they need dental work and likelier to use their dental plan will only have about $1000-$1,500 in benefits to use along with co-pays and limits. Dental insurance, even great dental insurance, is somewhat of a discount card for treatment. It helps but in many ways is not always worth it.
If you have employer-based health benefits that include dental, this is your chance to upgrade to a PPO, add a spouse or dependent or set up a health savings account. Health savings accounts use pre-tax dollars set aside to cover out-of-pocket medical and dental costs. If you need $3,000 worth of dental work and your plan only pays $2000, then set aside an extra $1000 tax-free, which could help.
Switching to PPO
PPO plans are the best option when it comes to picking or upgrading a dental plan. It is the best option because PPO plans pay the dental office for completed dental work. Wouldn’t you want treatment from a dentist that is being compensated fairly? HMO plans offer ‘no cost’ or extremely low fees for services. Many quality services that normally are part of or included in PPO plans are not covered by HMO and therefore chargeable to the patient. There are many reasons why HMO plans are not good for the patient and dentists, and we will cover that topic in a future post.
Things to look for when evaluating or picking a dental plan:
- Make sure it is a PPO plan!
- The maximum yearly benefit of $1,500 or more.
- Waiting periods. There shouldn’t be any…But If there is a waiting period, it should only be applied to major services (12 months)
- Deductibles ($25-$100)
- Two or more dental cleanings covered per year. Most people need three or four.
- Implant coverage
- Effective date and plan year (Jan-Dec, June-June, Sept-Sept)
You can always e-mail firstname.lastname@example.org with a screenshot or information of your dental plan options for our manager to evaluate.