When most people think about health insurance, they think first about covering costs of treatment for serious medical conditions or accidents. That's a natural thing to do. But there's another type of insurance that's equally important to your well-being dental insurance. Because dental disease is so common, being protected by dental insurance and using it wisely are essential safeguards for you and your family.
There's A World of Difference between Medical and Dental Disease...
Unlike medical disease, which can be both unpredictable and catastrophic, most dental ailments are preventable. Preventive care, including regular checkups and cleanings, is the key to maintaining your oral health. With regular visits to the dentist, problems can be diagnosed early and treated without extensive testing or elaborate and expensive procedures. That keeps the costs of dental care much lower than those of medical care.
Six Things to Consider When Choosing Your Dental Plan
What looks like a bargain today may not be a good buy in the long run. While your out-of-pocket costs are, of course, an important part of your decision-making process when choosing a dental plan, they are not the only criteria to use when evaluating your options. Your primary focus should be to determine whether the coverage will satisfy your dental care needs.
Consider the following:
- Does the plan give you the freedom to choose your own dentist or are you restricted to a panel of dentists selected by the insurance company?
If you have a family dentist with whom you are satisfied, consider the effects changing dentists will have on the quality or quantity of care you receive.
- Who controls treatment decisions--you and your dentist or the dental plan?
Many plans require dentists to follow treatment plans that rely on a Least Expensive Alternative Treatment (LEAT) approach. If there are multiple treatment options for a specific condition, the plan will pay for the less expensive treatment option. It's important to know who makes the treatment decisions under your plan. These cost control measures may have an impact on the quality of care you'll receive.
- Does the plan cover diagnostic, preventive and emergency services? If so, to what extent?
Most dental plans provide coverage for selected diagnostic services, preventive care and emergency treatment that are basic for maintaining good oral health. But the extent or frequency of the services covered by some plans may be limited. Find out how much treatment is allowed in any given year without cost to you, and how much you will have to pay for yourself.
- What routine corrective treatment is covered by the dental plan? What share of the costs will be yours?
While preventive care lessens the risk of serious dental disease, additional treatment may be required to ensure optimal health. A broad range of treatment can be defined as routine. Most plans cover 70 percent to 80 percent of such treatment.
- What major dental care is covered by the plan? What percentage of these costs will you be required to pay?
Since dental benefits encourage you to get preventive care, which often eliminates the need for major dental work, most plans are not generous when it comes to paying for major dental work, most plans cover less than 50 percent of the cost of major treatment.
- Can you see the dentist when you need to, and schedule appointment times convenient for you?
Dentists participating in closed panel or capitation plans may have select hours to see plan patients. They may schedule appointments for these patients on given days, or at specified hours of the day, restricting your access.