Well, if you just said yes to that, then you’re not alone!!
Dental insurance has become increasingly hard to understand and seems to be changing every year. Let me try to shed a little light on the some things you should know.
You may get dental insurance through your employer or you may buy it independently or in some cases the state offers insurance.
First – Let’s Discuss Employer Offered Insurance
If you are getting your insurance through your employer, then your benefits are based on what they have chosen for you. Each insurance company offer many plans to fit the price point that an employer is willing to pay for your premium. Sometimes you are responsible for a portion of this premium, other times the employer will cover the whole cost.
What’s covered and what’s not?? This is dependent on the plan your employer has chosen. There are thousands of different plans available.
Most dental insurance plans have an annual maximum. This is typically, but not always, going to range from $1,000 – $1,500 per year per person on the plan. Sadly, this is the same as it was 30 years ago but of course, dental fees are much higher as they are with everything. Now this doesn’t mean that you have $1,000 or $1,500 to spend before you will owe anything. What it does mean is that insurance will cover a portion of your dental work up to $1,000-$1,500.
Most often your cleanings go toward this annual max and are covered at 100% but not always. Other treatment that might be needed will be covered at varying percentages.
One trend that we are seeing more and more is insurance plans that will only cover silver fillings on your back teeth and not the white tooth colored fillings that are a better and more popular choice. What this means is that insurance doesn’t have to pay as much and you have to pay more. It isn’t unusual for dentists to not even use amalgam (silver) fillings anymore since there are better options available.
Purchasing Your Insurance Plan Independently?
If you are looking for me to tell you which plan to buy, I can’t help you! There are many plans available but what I have heard from patients is that the premiums are very high for what they are getting. We have had many frustrated folks come in thinking they bought one thing and finding out it doesn’t cover what they were expecting. It is hard to know what questions to ask when you are purchasing your insurance independently. I have put together a form that might help you to know what questions to ask when you call insurance companies. If you would like one, give me a call and I will be happy to email it to you.
State Funded Insurance
This is a whole other animal. To my knowledge this is offered based on income. This insurance is meant to maintain one’s dental condition and not to improve it. It doesn’t cover crowns or root canal treatment on any posterior (back) teeth and will only pay for silver fillings unless they are on front teeth. It does cover extractions.
This is a very limited explanation of dental financial options – but hopefully somewhat helpful.
