Research shows that people without dental benefits are less likely to get preventive dental care and more likely to need expensive extractions, dentures and emergency room treatment.
But even people with insurance often find dental treatments to be extremely costly, especially for more advanced care like crowns or implants.
Here are 6 things you should know about dental insurance, and ways that you can save on care.
1. Dental insurance differs from medical benefits. Dental insurance is designed to encourage preventive treatment. That’s why most dental plans pay 100% for preventive services, such as cleanings, X-rays and check-ups.
When it comes to basic restorative services such as fillings and periodontal cleanings, most plans cover 80% of the cost. You’ll commonly get just 50% reimbursement for procedures such as implants and crowns.
Also, dental policies tend to come with low annual maximums of $ 1,000 to $ 1,500 caps on what the plan will pay toward care.
2. Braces are often not covered. Dental plans you buy on your own in the private market generally don’t cover orthodontics. However, most work-based policies offer a $ 1,500 lifetime maximum payout toward the cost of braces.
The Affordable Care Act requires plans to provide dental insurance for children up to age 19. But children’s braces are generally covered only in severe cases that meet certain criteria.
3. Consider an HMO. Most dental plans sold today are PPOs, which give you access to a greater number of dentists.
However, if you expect to need a lot of care, consider a dental HMO. These plans limit you to seeing only dentists participating with the insurer’s network, and the office environment tends to be corporate in feel. But overall, costs can be much lower.
The monthly premiums are less expensive than with PPOs. Office visits require only a co-pay, generally of $ 5 to $ 10. And, unlike with a PPO plan, there is no annual maximum on coverage.
4. Discount plans. Discount dental plans can help to reduce the cost of dental care anywhere between 10% and 60% off of common charges.
But these are not insurance plans; they aren’t regulated by your state’s department of insurance.
To receive the reduced negotiated rate you must have your care provided by a dentist participating in the network.
You can find discount dental plans on the National Assn. of Dental Plans website.
5. Compare prices. Ask about the cost of your care upfront by requesting a pre-treatment estimate and then do some price comparison shopping before going for care.
You can find the average cost of the procedure you need by entering your zip code at www.fairhealthconsumer.org. Use this website to confirm you’re getting a fair price and to negotiate to further lower your costs.
You can also use the website to make sure the prices being offered by dental discount plans are truly discounted.
6. Dental schools. Schools of dentistry provide excellent treatment at a reduced cost. Typically the dental work is done by students learning to be dentists. They are supervised by a veteran instructor. You can find a dental school near you on The American Dental Association website at www.ada.org.