Dental insurance: Do or ditch?

Is dental insurance worth it? It depends on your needs. Having dental coverage can make it more affordable to get the dental care you need, but it is important to understand that most dental benefit plans do not cover all dental procedures. Ultimately, your dental treatment should be determined by you and your dentist, not by what is covered by your insurance.

What is the best dental plan? There are two main types of dental insurance: managed care and fee-for-service. Indemnity dental insurance is a type of fee-for-service plan that lets you see any dentist you wish. However, your insurance company only pays for care after you submit a claim. Preferred Provider Organizations (PPO) plans allow you to see any type of dentist and without a referral, but there are restrictions as to what is covered. Dental Health Maintenance Organization (DHMO) and Health maintenance organization (HMO) plans are more restrictive, requiring members to see an assigned provider who is within the insurance company’s network. Typically, PPO dental insurance plans are said to offer better service and have less limitations than DHMO/HMO dental insurance plans. Obviously, we recommend fee-for-service or PPO plans to give patients the freedom to select the best health care providers for your treatment needs.

Dental benefits are covered? You and/or your employer and the insurance provider agree on what the plan covers and how much it pays towards covered procedures. Your dentist is not involved in deciding the level of coverage. For instance, some plans have an orthodontic benefit.

How does orthodontic coverage work? If your insurance does provide coverage for orthodontic treatment, here are some things to keep in mind: only covered as a lifetime maximum (unlike other dental benefits, orthodontic benefits are not renewed annually), age limit (some plans only cover minors), and payment schedule (the policy must be kept during the entire treatment, typically 1-2 years). We want to help you maximize your insurance benefits and will do the leg work for you, from check on your benefits before starting treatment to filing claims for your insurance throughout your treatment. We understand that insurance can be confusing and are always happy to answer questions about your insurance benefits. If you are looking to change dental plans for the new year, talk to us and we can give you some tips. We serve patients throughout Orange County, and even throughout California.