How to Understand and Decide on a Dental Insurance Plan

Finding good dental insurance plans—or any good insurance—is stressful. How do you know if you have found a good plan? Remember that we would love to help you, so call us and talk about what plans you are looking at. We’ll do our best to help you understand your options. When you go over your options alone, however, keep in mind this list of things to look for:

What to Look Out For

A Waiting Period. Many insurance companies have a one-year waiting period where you are paying for insurance but cannot use it. If this is the case, you might be better off looking for a different plan or just paying out of pocket.

Limits. Dental insurance plans usually have a ceiling on what they will pay per year. This amount may be measured per family or per person. Consider the dental expenses you think your family will need to see if this plan’s limit will suit you.

Coverage. Some insurance companies will only cover silver fillings (the ones that contain mercury) and will not cover composite fillings for cavities. This is another red flag that may mean this insurance plan is not a good fit for you.

Stipulations. Every plan will have some stipulations about copays, pre-existing conditions, limits, and other things already mentioned. Be sure you look over what these stipulations are to see if they are compatible with your family’s needs.

Coverage Percentage. Every dental plan should state rather clearly what percentage of your dental fees they will cover (usually around 60 percent or 80 percent). But you need to ask if this is 60-80 percent of the doctor’s fees, or 60-80 percent of the insurance company’s set fees. Here’s the difference: insurance companies create set fees for what theythink a cavity or cleaning should cost, regardless of whether your Boise dentist’s fees are different. You can see how this could cost you, so make sure you clarify this with your insurance company.

Do Dental Patients Really Need Insurance?

The short answer is that it depends. Dental patients should look at what they need and what insurance would cover, but the decision is mostly personal preference. Here are some examples of what you could consider:

Mostly Preventative. Most older people probably just need preventative care, so simple dental insurance like a $700 limit to use on whatever the dental patient wants or needs is probably enough to cover biannual cleanings, check-ups, and the like. For those looking for another simple dental insurance option, flex spending accounts are generally a good idea as well.

A Waiting Period. If there is a waiting period, however, you may be better off without insurance and instead pay out of pocket.

For Lots of Dental Work. If you need a lot of work done on your teeth, really good dental insurance could be a huge help. But know that for something like dental implants, most insurance companies won’t cover much. Coverage for these procedures has improved over the years, however, so you may get coverage up to 40 percent.

The Bottom Line

In order to discover if you have a good dental plan and if it’s worth the investment, ask lots and lots of questions. And call us to go over your options! We’d love to help you find the best plan and can help you pick up on the red flags of a bad plan.

Any other questions about finding a good dental plan? Give us a call or stop by our office!