As promised, I’m continuing to expand on one readers question about dental insurance. This week I’ve chosen to focus on traditional dental insurance which is the most common type available.
This kind of insurance can be purchased by individuals or families, offered as part of a benefits package by employers in which employees may choose to take part. There are so many different plans out there and they all provide varying amounts of coverage. This explanation should serve to provide an overview of dental insurance without delving into the minutiae of each individual plan.
Traditional insurance polices provide a maximum benefit amount per year. The insurance companies lump procedures into categories termed preventive, basic and major. Sounds easy so far, doesn’t it. Preventive procedures would be considered procedures performed in order to eliminate or reduce dental disease. This would be routine teeth cleaning, fluoride treatment and sealants for children as well as x-rays and routine exams. Basic procedures would be fillings and basic tooth extractions.
Major procedures include crowns, bridges, dentures and treatment that is of a more extensive nature. All of these procedures with the possible exception of preventive services are subject to co-payments of between 20 percent and 50 percent plus a deductible. Dental insurance maximums are low and generally range between $1,000 to $2,500 per year with $1,000 to $1,500 benefit maximums being the most common.
Most of these traditional plans allow you to choose your own dentist. Some plans increase the level of benefits if you choose a dentist from their “list.” That list is comprised of dentists who have chosen to accept the fees that the particular insurance company feels is fair for that particular grouping of services.
It is important to consider the list of services provided very carefully because the insurance company can exclude certain services (ie. Dental implant treatment). Also, there may be waiting periods for certain procedures (generally six months to a year) and omissions for pre-existing conditions (ie. Missing teeth that need to be replaced).
Dental insurance is just like any other type of insurance in that it fulfills a need. The most important thing to determine is what your immediate needs are and which type of plan will benefit you and your family the most.
As always, I appreciate the questions. I will delve more into this subject in the following weeks. You can reach me by e-mail at firstname.lastname@example.org or by phone at (239)389-9400.
Questions can be sent to Fred Eck, D.D.S. at Marco Dental Care, 950 N. Collier Blvd., Suite 305, Marco Island; call 389-9400 or visit marcodentalcare.com. He received his Doctor of Dental Surgery at the University of Detroit Mercy and is licensed by the Florida State Board of Dentistry.