Should I Buy an Individual Dental Insurance Plan? « Health Insurance Advisory

Should I Buy an Individual Dental Insurance Plan?

A healthy smile is the signature of wellness. It is not just about being good looking and confident, though. Preventing disease that affects your whole body is key to maintaining a healthy being. Since your mouth is the primary access point for the inner systems of the body, good health begins with a healthy mouth and teeth that are free of decay.  An individual dental insurance plan can help ensure your overall health by covering routine exams, preventive care, diagnostic, basic and major dental services.

There are several types of individual, student and family dental insurance plans, including:

1. Dental Maintenance Organization (DMO) – a DMO requires that you select a dentist from a limited panel of providers.  Your dental care is coordinated through this dentist and you are often required to obtain a referral to see a dental specialist.  There is no coverage if dental care is rendered by an out of network provider.

2. Preferred Provider Organization (PPO) Dental Insurance Plan – unlike a DMO, you can obtain dental care from any network provider, but are not required to use a network provider.  Many PPO dental insurance plans will pay more of the cost (higher percentage coinsurance) when a network provider is used. This is referred to as a “PPO incentive plan.” However, some plans pay the same coinsurance percentage for in and out of network providers. The big financial advantage to you for using a network provider is lower out of pocket cost, as you will not be responsible for the difference between the dentist’s billed charge and the allowable or reasonable and customary amount.

3. Indemnity Dental Insurance Plan – like a PPO dental insurance plan, indemnity dental insurance is very popular today because you can use any dentist or specialist.  Since the plan pays based on the allowable or reasonable and customary amount for each procedure type, you may owe the difference between the dentist’s billed charge and the allowable or reasonable and customary amount.

4. Fixed or Fee Schedule Dental Insurance Plan – this type of individual dental insurance plan actually pays a specific dollar amount that is listed in the policy for each covered dental expense. If your dentist’s billed charge is more than the amount listed in the fee, then you are responsible for the difference.

5. Dental Discount Plan – although not insurance, dental discount plans are very common today because they help make dental care more affordable and are better than not having any form of individual dental insurance. Discounts typically range from 25% to 40% off retail charges.  Many companies charge for a dental discount plan, but offers a free health discount plan that provides savings on dental care, prescription drugs and vision services at national chains and local retailers across the country.

In terms of cost, individual dental insurance plans can be as inexpensive as $8 to $35 per month for one person and $50 to $125 per month for a family dental insurance plan. Routine exams, preventive care services and diagnostic care are usually paid at 100% with no waiting period, while basic and major services are often covered at a lower coinsurance percentage, such as 80% or 50% and subject to a waiting period (6 months or longer is very common).

Whether you are looking for full coverage dental insurance that provides comprehensive benefits with few out of pocket costs to you or inexpensive dental insurance that focuses more on preventive care, we can help you.  For individual dental insurance plan quotes, click here or call today at 800-403-8511.

To download and print your free health discount card, click here.



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