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What You Need to Know About Dental Insurance



Dental insurance is a type of coverage that helps pay for oral health care. Many people think that dental insurance is only for those who have teeth, but it actually covers much more than that. It can also cover preventive care, such as cleanings and x-rays, as well as procedures like fillings, crowns, and bridges.


Why Does Dental Insurance Matter?

It’s important to have dental insurance because dental problems can lead to larger health problems if they’re not taken care of. For example, gum disease has been linked to heart disease, stroke, and diabetes.


There are two types of dental insurance: indemnity plans and managed care plans. Indemnity plans will reimburse you for a portion of your dental expenses after you’ve met your deductible. Managed care plans will usually offer you a list of participating dentists from which you can choose. These are the most common types of dental insurance:


Dental Health Maintenance Organizations (DHMOs)

A DHMO is a type of managed care plan. With this plan, you will be required to pay a monthly premium as well as a copayment or coinsurance for each visit to the dentist. DHMOs typically have low monthly premiums but higher copayments or coinsurance.


Preferred Provider Organizations (PPOs)

A PPO is another type of managed care plan. With this plan, you will also be required to pay a monthly premium as well as a copayment or coinsurance for each visit to the dentist. PPOs usually have higher monthly premiums but lower copayments or coinsurance. They also allow you to see any dentist you want, although you will likely get a greater benefit if you see a dentist who is in the network.


Dental Indemnity Plans

A dental indemnity plan is an indemnity plan that reimburses you for some or all of your dental expenses after you’ve met your deductible. This type of plan usually has higher premiums and requires you to submit claims to the insurer in order to get reimbursed.


What to Be Aware Of

Dental Insurance & Medical Insurance Are Different

Dental insurance is not the same as medical insurance. Medical insurance covers illness and injury, while dental insurance covers oral health care. This means that dental insurance will not cover procedures such as wisdom teeth removal or root canals.


Dental Insurance May Have a Waiting Period

Some dental insurance plans may have a waiting period for certain procedures, such as orthodontics. This means that you may have to wait a certain amount of time, usually 6 to 12 months before the procedure is covered.


In addition, dental insurance, like other types of insurance, may not cover pre-existing conditions. This means that if you have a dental problem when you first get dental insurance, it may not be covered until after a waiting period.


Expect Out-of-Pocket Costs

Even with dental insurance, you can expect to pay some out-of-pocket costs. This includes your monthly premium, deductible, copayments, and coinsurance.


Dental Insurance May Have an Age Limit

Some dental insurance plans have an age limit, which means they will only cover children up to a certain age. For example, some plans may only cover children up to age 19.


Emergency Services Are Rarely Covered

Dental insurance rarely covers emergency services, such as a root canal or tooth extraction. This is because these procedures are usually not considered to be preventative care.


Final Thoughts

Dental insurance is an important type of insurance to have because it can help you pay for the dental care you need. Be aware that there are different types of dental insurance, and each type has its own benefits and drawbacks.


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