Dental Insurance Guide
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Dental insurance refers to the cost which one has to bear in order to cover one’s dental expenses. The National Association of Dental Plans states that 46% of Americans do not own dental insurance.
Dental insurance covers all or some of the dental expenses for which one is required to pay a premium to the insurance provider. Dental insurance can be for an individual, a group or company and also for a family.
Dental insurance refers to the cost which one has to bear in order to cover one’s dental expenses. The National Association of Dental Plans states that 46% of Americans do not own dental insurance.
Dental insurance covers all or some of the dental expenses for which one is required to pay a premium to the insurance provider. Dental insurance can be for an individual, a group or company and also for a family.
Group dental insurance is usually done by an employer for the employees. The cost of this is deducted from the employees’ salary.
Table of Contents
Dental Insurance: Types of Plans
There are basically two types of dental insurance plans:
- Preferred Provider Organization (PPO)
- Dental Health Maintenance Organization (DHMO)
Both these categories of dental insurance have their own benefits and drawbacks.
Dental Insurance: Coverage
Dental insurance generally covers the following, although the coverage may differ from one insurance provider to the other:
- Dental insurance covers dental cleaning for removing plaque and tartar by a professional, which may be needed from time to time.
- Dental insurance may also include extraction of teeth, needing surgery which can be included in non-cosmetic surgery.
- Dental x-ray is also covered by dental insurance. Taking a dental x-ray is important because it shows the exact condition of dentition.
- A person suffering from cavities and chippings can get fillings done. This is also covered by dental insurance.
- Dental insurance also covers situations needing urgent dental attention in case of an injury or accident. The emergency may include tooth replacement or dental surgery.
All dental insurance providers make tall claims, but one needs to weigh the pros and cons carefully before parting with their hard earned money as there are several loopholes which one needs to be aware of.
[break]Dental Insurance Plan
Dental insurance plan can be referred to as a plan which covers all or partial expenses when one visits a dentist either for routine check ups or for any dental assistance.
One who visits the dentist or needs any dental assistance is required to pay a certain amount called premium at regular intervals to the insurance provider. One who has acquired a dental insurance plan can pay the premium according to ones choice.
Mode of Payment:
The premium paid by the one who is insured is either on a monthly basis, or quarterly basis where one pays the premium every three months or can pay it annually.
Dental insurance plan may differ greatly depending on the type of dental insurance plan one is opting for. Due to the difference in the dental insurance plan, the premium which one has to pay differs too.
Dental insurance plan coverage:
A dental insurance plan may vary but generally a dental insurance plan covers the following:
- Dental insurance plan covering normal cleaning:
- Normal cleaning may include removal of plaque and tartar which is not removed by brushing.
- This dental insurance plan is quite important because the cleaning is done by a professional and there are chances that one might discover a dental problem which might need further dental assistance.
- Dental insurance plan covering x-rays of dentition:
- A dentist gets to know the exact condition of the teeth and the gums. Dental X ray dental insurance plan coverage is vital.
- Dental insurance plan covering fillings and crowns:
- If one is suffering from dental cavities or chips and needs fillings this dental insurance plan can partially (usually covered partially) save one from this costly affair making it affordable to the common man.
- Dental insurance plan making emergency tooth replacement affordable:
- In the event of an injury or an accident if one loses a tooth, emergency tooth replacement can be done which is covered by dental insurance plan.
- This is of utmost importance because losing a tooth or more than one tooth can affect ones lifestyle and also inflict a negative impact on ones self confidence.
- Dental insurance plan covering non cosmetic surgery:
- In some cases, extraction of teeth may require one to be operated on which can be a very costly affair.
Individual Dental Insurance
Dental individual insurance is insurance wherein an individual is covered for various dental ailments against the payment of premiums to the insurance company.
Many believe that individual dental insurance is more expensive than group dental insurance. But choices differ and so do people.
The dental individual insurance policy usually covers the following dental ailments:
- Non cosmetic surgery: Dental surgery may be required in some cases for the extraction of a tooth. Dental individual insurance does not cover cosmetic surgery for beautification.
- Emergency tooth replacement: Dental individual insurance pays for emergency tooth replacement in case of an injury or accident.
- Dental x-rays: Dentists often refer to dental x-rays to know the exact condition of the teeth and gums. Unless this is covered under individual dental insurance, one may find it quite expensive.
- Normal cleaning: Simple cleaning of the teeth is also covered by individual dental insurance. Cleaning is done to remove tartar and plaque, which do not go away with normal brushing.
- Covering fillings and crowns: An individual suffering from cavities and chips can go for tooth fillings covered by dental individual insurance.
- If one is a non-smoker and can prove that to the insurance provider, the individual stands a better chance to buy dental individual insurance with good coverage.
- Besides smoking, the policyholder’s age also affects the policy price and cover. With age, teeth problems increase. So, an older person has to pay more for buying dental individual insurance.
- Tips to Buy Dental Individual Insurance
- Prior to acquiring individual dental insurance, one must keep the following points in mind:
- Waiting period under the policy: Waiting period defines the date from when the dental individual insurance policy will be effective.
- Insurance providing companies differ in their offer and one needs to check the fine print and read between the lines.
- There are a few companies that pose to offer some services for free. One should not fall into a trap and ascertain the feasibility of the dental individual insurance plan.
Group Dental Insurance
Group dental insurance is an insurance which covers a group of people for the dental ailments and dental assistance of the various employees of a particular company.
In the United States Of America, approximately two thirds of the working population is covered under group dental insurance. Statistics have proved that employees of a company value health insurance plans after their monetary assurance.
Group dental insurance plans offer a wide range of plans which are flexible and designed to suit the requirements of the employees.
Benefits of group dental insurance :
- If one acquires a group dental insurance plan through a company instead of an individual, one can avail of better rates.
- There are several tax benefits one can avail of for opting for a group dental insurance.
- The employees can pay their share of monthly premiums of group dental insurance through pre-tax dollars.
Eligibility conditions for group dental insurance:
The eligibility conditions for qualifying for a group dental insurance may vary from company to company and differ from state to state.
- The company should consists of at least two active members, officials or partners, employees. They should be verified by the Wage and Tax Statements for example DE-6 in California and NYS-45 in New York.
- Companies launched for reasons other than for acquiring a group dental insurance are verified by certain documents like:
1.An article of incorporation
2.An article of organization
3.A business license - The company fulfills the preset employer contribution percentage set by the group dental insurance company.
Automatic inclusion in group dental insurance:
There are several companies providing auto group dental insurance.
Under this scheme a new employee gets automatically enrolled for the group dental insurance benefit from the time one is on board.
Working of the group dental insurance:
The group dental insurance works in a very simple manner. The group dental insurance provider contacts the company, for whose employees the group dental insurance is to be carried out.
The group dental insurance provider:
- ascertains the number of people to be covered,
- the expenditure involved in covering the dental ailments,
- provides a group dental insurance plan to suit individual requirements.
- Makes the group dental insurance plan known to the employees covered.
Through a group dental insurance a company can attract better employees. Similarly, the employees too can benefit from the group dental insurance protection.
