Dental Insurance, Health Insurance

Dental Insurance | Information & Benefits

Dental Insurance

Most health care costs today have gone through the roof and dental care is no exception. It is therefore imperative that you have dental insurance as a financial safety net, should you face a large bill for dental care. Studies have shown that many people put off going to the dentist due to the large costs involved. On the other hand, you are offered a wide range of insurance plans by most insurance companies to meet dental care expenses which can be availed of. You can thus customise plans to meet your specific requirements.

The question that is bound to crop up first is how dental insurance really works.

There are three types of plans.

  • Health Maintenance Organisation (HMO) is a plan where you have to compulsorily visit a network dentist to avail dental insurance benefits. The problem here is that you have to depend on one dentist or dental care facility if there is no other networked dentist in your area.
  • Preferred Provider Organisation (PPO) permits you to consult a non-network dentist. However, in that case, you share of the total cost of treatment will be more than HMO. This is the most opted for plan and you have to pay a certain amount to the dentist upfront before the plan starts off. There are certain slabs for dental care under PPO. For preventive dental care, insurance coverage is 100%, for general treatments like cavity fillings it is 80% and 50% for bridges and extractions.
  • Indemnity plan is one where you take out dental insurance, consult any dentist of your choice, pay the full amount, submit the claim and then wait for the reimbursement to come through. Both this indemnity plan and PPO dental plans have the annual maximum benefit which is the amount you get reimbursed per year for dental care.

While evaluating the benefits across plans, it has to be understood that overall dental care is inclusive of ancillary services availed too. Take the case of a dental technician who has completed the diploma in dental technology program and is responsible for repairing and constructing dentures, partial dentures, crowns and bridges. The fees and cost of orthodontic appliances are also payable by dental insurance. Incidentally, dental technician courses are conducted by various institutes of which ACFE is considered to be on top of the list in terms of quality of classroom and lab training.

Dental insurance can either be group insurance or individual insurance. In the first case, employees of an organisation form a group and get the benefit of very low dental coverage as some premium is paid from salary on a continuous basis. The other is the individual insurance plans which will pay for coverage like group plans but has certain restrictions. These are usually 12 month contracts and have a cooling off period of 6 to 18 months. This means that anyone wishing to go for major and expensive dental procedures have to wait for this length of time before availing dental insurance. This is primarily to discourage people from taking dental insurance just before a major treatment and then cancelling the plan once it is over.

It is always advisable to take out dental insurance early. It is a wrong notion to think that only elders face oral and dental issues as even teenagers have cavity problems. The earlier you start the lower will be your share of the bill in case of a major procedure at a later date.