Dental Insurance Plans – What questions to ask

Shopping for an individual dental insurance policy can be a tricky proposition. Knowing exactly what coverage you are getting for the amount you are paying is difficult to evaluate if you don’t deal with insurance policies on a regular basis. Individual policies tend to differ in a few key areas from the dental policies offered to employer groups.

Here are a couple of key questions to ask your insurance broker or insurance representative before signing up:

Does this plan have waiting periods? Some individual plans cover only preventative services (cleanings, exams, x-rays) from day one, and require you to be enrolled for 3 months to 1 year before covering other dental services. If you need crown or bridgework, and are hoping to find dental coverage that will help, this is an important question to ask.

Does this plan have a missing tooth clause?   A policy with a missing tooth clause will not cover the replacement of teeth that are missing or extracted prior to the effective date of your policy.   If you are considering implants or bridgework, or dentures to replace missing teeth, you will want to ask about this clause.

Is this a dental HMO plan, or a PPO plan? Most insurance companies offer both, but few dental offices accept dental HMO, or DMO plans. If you are not sure if your dentist is a contracted provider for the plan you are considering, call your dentist before signing up. See our PPO plans.

After evaluating individual dental policies, you may wonder if adding dental coverage makes sense for you.   If you typically see the dentist only once or twice a year for a cleaning and exam, you may end up paying more for dental coverage than it pays in benefits. For the cavity prone, however, it may be well worth the cost of coverage.  Knowing (or estimating) your future dental expenses will make that calculation a lot easier.  If we can help with that, or answer any other insurance related questions, please feel free to contact our office.