Dental
Coverage
Dental plan or dental insurance: which is
best for you?
Dental
coverage is available in a wide variety of forms.
You can get PPO dental insurance, indemnity, HMO
dental insurance, discount dental plans and more.
The
main distinction is between dental insurance and
dental plans.
Dental
insurance works like regular insurance. You pay a
monthly fee and must pay a deductible, a co-pay
amount (a percentage of the dental services you get
- usually between 20-50%) and there is a maximum
amount it pays per year. After you hit their max
you must pay 100% of the dental service.
Dental
plans are much cheaper. You just pay a certain
amount for the whole year. You pay a reduced rate
for any dental services you get during the course of
the year from a dentist within their network.
Some
questions to help you decide
which dental coverage is best for you:
1. Do
you foresee large expenditures for your dental needs
this year?
Carefully consider each option. If you think
these dental fees will add up to more than the
dental insurance plan covers then it's best to go
with a dental plan.
For
example, if you need 3 root canals (ouch!) and
each one costs $900 then if you have a dental
insurance plan that costs $35/month and has a $750
maximum cap with a 20% co-pay you would end up
paying approximately $2360 for your dental care
for the year.
With
a dental plan that costs approximately $100/year
and gives a 50% discount on services your total
out of cost expenditures for the year would be
$1450.
2. Do you
foresee that your dental needs will be 'normal' this
year?
If so, a dental plan
is usually cheaper. You pay one low fee for the
year and don't have to pay an ongoing monthly
fee. Plus, there are no claim forms to deal with
and you don't have to wait x amount of days to get
approved by the plan provider. Coverage starts
almost immediately.
Be aware though that
with a dental plan you will have to pay more out
of pocket at the time the dental service is
provided (usually around 50% vs. a dental
insurance's approximate 20% co-pay.) Of
course you won't have the monthly ongoing fee that
you would with dental insurance coverage so if
your needs are relatively normal then a dental
plan is cheaper.
3. Do you
have a specific dentist that you want to go to?
If so, check and see
what plans the dentist is a member of and see what
insurance the dentist accepts then shop around.
4. Do you
foresee having orthodontic needs this year?
If so, you are going
to pay regardless of whether you choose a dental
plan or insurance. Not all dental plans or
insurance provides discounts for orthodontic
services, but the good ones will provide at least
some (usually around 20% for dental plans, it
varies for insurance). Depending on
your orthodontist you can sometimes do a
combination of plan and insurance which can cut
your out of pocket expense but not all
orthodontists will accept this so you need to
check with him or her first.
For this month's top
picks for best dental plan and best dental
insurance, click here.
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rights reserved.
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