Did you know that over 90% of people over the age of 20 have at least one cavity? 85 percent of Americans believe oral health is especially important to their overall health. About 78% of Americans have dental coverage. Dental care is necessary. It is important to learn the importance of dental coverage.
What is dental insurance?
Having a dental insurance plan covers a portion of basic dental expenses that you may use during a year. The plan details outline how much you pay each month for coverage. It also says how much of your covered dental procedures will cost. Most people get dental insurance through their employer, and it is typically separate from your health insurance plan.
Here are common terms that you need to know:
- Deductible: the amount you need to pay before your insurance begins to cover costs.
- Copay: An amount you pay for dental visits and procedures.
- Coinsurance: The percentage of dental expenses you pay after you have reached your deductible.
- Maximum benefit: The yearly limit of how much your plan will pay to cover costs each year.
How does dental insurance work?
Dental insurance provides coverage to help pay for dental care. You pay a premium to have coverage unless your employer offers it to you for free.
Most dental plans use a 100/80/50 coinsurance model. This means that once you meet your deductible, you could get 100% coverage for preventive dental care, 80% coverage for basic dental procedures, and 50% coverage for major procedures, if you receive care in your network.
The dental coverage waiting period is the time between when your coverage starts and when you can get full coverage for some dental services. Many dental plans do not include waiting periods for teeth cleanings or exams. But for basic procedures, the waiting period could be from 3 to 6 months. For major dental work, the waiting period could be anywhere from 3 months to a year.
Always check your plan details for coverage limits before scheduling an appointment or procedure.
What does dental insurance cover?
Dental insurance coverage typically covers three areas of dental care: preventive, basic, and major services. Dental plans usually cover 100% of preventive care, 80% of basic dental procedures, and 50% of major dental procedures.
Preventative Care
For preventive care, most dental insurance plans will cover 100% of the cost of in-network routine preventive care after you meet your deductible. Preventive treatments include bi-annual dental cleanings, exams, and dental X-rays. Most dental insurance plans cover 2 cleanings per year, which is every 6 months.
Basic Dental Procedures
Typically, most dental plans cover 80% of basic dental procedures. Basic procedures include fillings and non-surgical extractions. Most likely, you will have to pay a larger amount if you have not reached your deductible. Always be sure to ask your provider how much a procedure will cost and/or how it will be billed to avoid surprising costs.
Major Dental Procedures
A typical dental plan covers major procedures at a cost-sharing of 50%. Major procedures include crowns or dentures, and other services. Having a good dental plan will partly cover crowns, root canals, oral surgery, panoramic X-rays, and periodontitis treatment. Some factors could affect how much you pay; this could be your deductible or if your dentist is in the network.
What Does Dental Insurance Not Cover?
There are services that your dental insurance plan will not cover. For these services, you will have to pay out of pocket. The services may include teeth whitening, cosmetic dentistry, and braces. Orthodontics may be covered but check your policy for coverage details. If the policy provides coverage for these services, it could be a smaller percentage. Dental plans might not cover athletic mouthguards, night guards, and nitrous oxide.
Are you interested in dental insurance?
If you’re an employer, speak to one of our insurance agents now about receiving a quote for dental insurance. Contact the Agency Team or call (513)985-4481. You can also start a chat with our team in the bottom right corner and someone will assist you.
Dental coverage is inexpensive and offers excellent peace of mind for employees. You can always make the coverage optional to keep costs low.
