Dental health should be one of the top priorities for any human being owing to the critical role our teeth have.
Our teeth enable in enhancing our facial looks by keeping the muscles in check and help to amplify our smile.
Without teeth, chewing food would be a significant problem. On the other hand, our teeth are prone to problems such as tooth decay or in the case of an accident one could end up losing almost all of the dental formula.
This necessitates a preplanned measure to check our dental concerns possible through a dental insurance plan.
What is dental insurance?
Dental insurance has a similarity to medical insurance and works in almost the same manner.
It offers benefits such as regular checkups, x-ray services, dental cleaning, among other services required to maintain a healthy dental formula.
To receive these benefits, one is required to pay monthly premiums. The services offered are differentiated by the services per package and the accompanying premiums.
Some of the specialized services include oral surgery, orthodontia, and dental implants
Types of dental plans available
A broad classification of the dental coverage gives rise to two dental plans namely indemnity and managed care plans.
Of concern in this classification is how bills are payable, choice of dental provider and out-of-pocket costs. Indemnity plans offer a lot of flexibility in choosing a health provider and therefore suitable for people who are always traveling from one place to another.
On the other hand, managed care plans have flexibility in their mode of payment for your services.
This could be attributed to their restrictions on the service provider for they liaise with selected dentists hence you receive dental services freely.
This is achievable through maintaining a dental provider network where the participating dentists agree to offer services at predetermined rates and then submit the claim later for you.
For the case of indemnity plan, bills are paid on demand where you will have to submit a bill before payments are made. This implies that you will first incur out-of-pocket costs and then obtain reimbursement from your dental insurance provider.
Therefore, it is up to you to select the preferred plan knowing that, managed care plan offers you lower transaction costs and less paperwork while indemnity plan offers you a broader choice for dentist selection.
Breaking dental insurance plans further
Dental discount plans: These can be considered as partial coverage since they do not provide full coverage.
They only address the common dental procedures, and the benefits are available as the patient needs them.
Standard individual plans: It is one of the most popular among many people and covers the costs of most preventive checkups.
Every year, a client is offered two checkups X-rays and cleaning services, and where additional work is required, the insurance will cover it partially for you.
Therefore, it is an improved version of the discount plan.
Preventive-only plans: This is a suitable dental insurance plan for those who do not require regular dental services.
It is a low premium plan and helps you cover preventive checkups and cleanings. It is an ideal plan for young people who have a healthy dental formula.
The family plans: This is similar to standard individual plans only that, they consider a family benefit deductible on the total payments.
For instance, if the payments for a dental plan are $50 per head, this plan has a cap of a maximum amount of $150 payable per family.
Therefore, where you wish to cover many family members, only three will be charged.
Gold and premium plans: Some insurance firms will call it a gold plan while others term it as premium plan.
Whichever the name, premiums are usually higher than in other plans, but the benefits are also more, for instance, you may end up with more cleanings per year or other services of choice.
Factors to consider when acquiring a dental insurance plan
As listed above, there are many plans at your disposal, which may be contradicting hence the need to have some basic knowledge on this issue.
The deductibles: The deductible refers to the total sum of money incurred or payments you need to make before the dental insurance provider offers cover for the services.
Note that, plans with low premiums have a high deductible while plans with higher or expensive premiums have low deductibles.
Therefore, people with a sound dental health can opt for the low premium plans, which have a high deductible since they will rarely use this service.
However, if you have issues with your dental health, the high premium plan with low deductibles is suitable for you, as you will often use this service ensuring proper utilization of your premiums.
The level of coverage: Different dental insurance plans will offer certain services. Some cover prescriptions, checkups, specialized visits, dental care among others.
The premiums also paid differ with the scheme.
However, it is advisable to choose a plan that covers a majority of services, which is termed as full coverage dental insurance.
The co-payments: Once you hit your deductible limits, you will be required to pay an amount for treatment termed as co-payments.
Dental insurance plans with lower co-payments have high premiums while those with high co-payments have less premiums.
Classification of the plans
A dental health insurance provider classifies their services into segments for easy administration and premium setting. This classification can include
Preventive care: As the term states, the aim is to prevent a condition from arising.
It comprises of routine services such as cleaning, x-rays, among other routine services.
Basic care: Includes services such as fillings, basic restorative work, and non-routine services.
Major services: These include crowns, root canals, and bridges among other specialized services.
Factors considered before you are offered a dental insurance plan
For insurance providers, the essence is not only to offer you the dental cover but also to have a profitable business.
Therefore, they will consider several factors before accepting your application.
However, with some insurance providers such as Blue Shield and Cigna dental insurance, they are more lenient on the measures.
Some of the factors considered are;
Health condition: Some conditions such as diabetes and cardiac issues can affect your health as well as your teeth.
Additionally, some prescriptions can cause a dry mouth, which can allow bacteria growth in the mouth, which is of concern to your health.
Age: Young people have less dental health issues as compared to the old who have issues with their teeth.
As years go by, it is advisable to switch to a plan with more services such as cleaning, and gum treatment.
For the case of children, especially the teenagers, special care need to be accorded for sealants and orthodontics.
Habits: For those who have habits such as excessive chewing of caddy, and avoid brushing your teeth, then you might need a more expensive plan while those with good habits then you can consider opting for a cheaper insurance cover.
Genetics: It is common for some family members to suffer from a specific dental condition, which can be seen from the family health records.
Dental insurance review
It is important to compare dental insurance providers so that you have the best quotes and best services. This is especially so when going for dental insurance plans for seniors.
The following review is based on selected insurance providers, but many more are available in your region.
Blue Cross dental insurance: This is the largest dental PPO network with affordable monthly premiums and without deductibles for preventive, diagnostic and checkup services.
PPO means a preferred provider organization. The insurance plans provided offers coverage for x-rays, cleanings, and exams as a component of your annual preventive care provided by an in-network dental provider.
Coverage for specialized services such as bridges, denture, crowns, and orthodontics is also available on selected plans.
Some of the plans available include; PPO Pediatric, EPO standard, EPO standard with vision, PPO standard, PPO standard with vision, PPO plus standard among other plans.
Metlife dental insurance: Is a leading global dental health insurance provider with over 191,000 dentists within their network provider nationwide.
It has efficient services with no waiting time on certain services for groups with no prior dental issues.
For companies wishing to offer dental insurance services for their employees, this is one of the best dental insurance companies offering plans such as preferred dentist program and managed dental plans.
Cigna dental insurance plans: They have a slogan that a dental cover keeps you smiling.
They offer the clients the chance to add a dental insurance under an existing medical plan for ease in management of health plans.
Their dental plan offers extensive coverage that is far more than the routine cleanings and x-rays.
With their in network services, you save more but even with the out-of-network services you enjoy numerous services including preventive care, basic care and major services.
Their insurance plans include;
Cigna dental preventive: the plan has no yearly maximum, or deductible, and Cigna pays all your in-network diagnostic and services and offers discounts for orthodontia and restorative services.
Cigna dental 1000: Offers coverage for preventive, restorative, and diagnostic services and offers discounts for in-network orthodontia.
Cigna dental 1500: Cover includes diagnostic, preventive, and restorative services. It also includes orthodontia coverage for all ages.
Advantages of Cigna
Convenient billing and payments, no claims submissions, no need for a primary dentist, online and mobile access on the go, customer service, national network access.