Choosing insurance for an individual is different than choosing insurance for a family. Children are more likely to need higher cost dental work than adults. Years may go by without any major dental need until a couple of root canals and crowns sets one back several thousand dollars. One must consider how much total coverage is provided, what is actually covered, how much copays are and which dental offices will take the insurance. It is highly recommended by iHealthCoalition.org to get at least three quotes before committing to a policy.
Dental insurance typically is not like major medical health insurance where most procedures are fully covered except for a small copay. Dental insurance usually has a low maximum per year of coverage. Many policies only cover a maximum of $1,000 per year per person insured. That may sound like a lot for dental work, but many single procedures cost more than a thousand dollars. Dental insurance providers usually try to work out an agreement with dentists to reduce costs, but if dentists are not getting what they perceive as a fair value for the work completed, they will drop that provider from the list of insurances they take. This puts patients in a bind since specialists typically will not accept many discount insurance plans.
Co-pays are a major concern for anyone seeking to find a dental insurance provider. Copays are not standard, and consumers can get lost in what procedures are covered at what copay level. Some copays can be quite high with the patient having to pay a large sum of money upfront just to have a small portion covered by the insurance. Some procedures and dental appliances are not covered at all. For example, some policies will pay 100% for simple extractions. However, if a patient needs to have several extractions, some of them may be complicated extraction types under the insurance that are not fully covered. Then the needed dental appliance to replace the missing teeth may not be covered at all and may cost over a thousand dollars.
Be sure to read the fine print of the policy, and be sure to call the provider of the insurance each time before a procedure is done in order to be certain of the costs involved. There is a necessity to get things in writing from the dentist. If a dentist states that the tooth he is going to pull is a simple extraction, and it is known that type of extraction is covered at 100%, it is important to get a statement from the dentist of what he will be billing for before the procedure is done. Talk about certain unforeseeable things that can change the circumstances of the work being done.
Work done by an oral surgeon is usually at a much higher cost than a dentist though they are both Dental Medical Doctors. Oral surgery usually involves certain anesthesia administration and medications beyond the local injection of lidocaine. Most policies do not cover these anesthesia types. Ask the provider of the dental insurance if policy supplements can be purchased to cover all of these extra costs.
Be sure to read the full policy for each quote that is received. Ask questions about oral surgery, anesthesia, dentures, bridgework and other orthodontic appliances. Be sure to ask for a list or book of local dentists and oral surgeons who accept the insurance. Finally be sure to inquire about policy supplements that may be available for unique situations.