You Can Just Get Dental Insurance … If That’s All You Need

If your employer doesn’t provide dental insurance, you may wonder how to just get dental insurance coverage. After all, preventive dental care can go a long way toward protecting your overall health. Fortunately, it’s possible to purchase individual dental insurance plans for yourself and your family. Even better, you don’t have to wait for an enrollment window or qualifying event to sign up.

The key is doing your homework.

“As a dentist, I see a lot of patients who do not exactly know what they have in terms of their dental insurance benefits and coverages,” said Dr. Min Jin Kim, chief of pediatric dental services at Jersey City Medical Center.

Here’s what you need to know.

Know Your Needs

First, take stock of the kind of dental care you need now, and what you’ve tended to need in the past. “You will buy a different plan if all you need are routine checkup exams and cleanings versus if you will need a lot of treatment in the coming year,” Kim said. “You want to sign up for a plan that has good coverage for the type of dental work you will be getting.”

If it’s been some time since your last exam and you suspect you might need some major work, you may want to get a little more coverage than if you’re already in good dental health. There are generally three levels of dental insurance plans:

  • Preventive care. This level usually includes exams, basic health screenings, cleanings and X-rays.
  • Basic services. These usually include fillings and routine tooth extractions.
  • Major services. This level often includes root canals, bridges and crowns, and oral surgery.

“You want to sign up for a plan that has good coverage for the type of dental work you will be getting.”Dr. Min Jin Kim, chief of pediatric dental services at Jersey City Medical Center

Review the Types of Dental Insurance Plans

Individual dental insurance plans come in several models. “Not all dental insurances are created equal,” Kim said. “In order to maximize the value of your dental policy, there are a few things that you as a consumer must consider before signing up for one.”

The types of dental insurance plans include:

  • Preferred provider organizations. These dental insurance plans provide coverage for a network of dentists who agree to provide discounted rates for their services. Preventive services are usually completely covered, while you may need to pay a percentage of any services provided at the higher levels, usually called basic or major. There is also often an annual maximum and an annual deductible.
  • Fee schedule plans. Under these dental insurance plans, covered services are paid for at a specific reimbursement rate, regardless of whether you see a dentist who is in a network. These dental insurance plans also have annual maximums and deductibles.
  • Cleaning-only plans. These bare-bones dental insurance plans pay only for an annual tooth cleaning and exam, but may come bundled with other services or coverage, such as vision insurance.

Compare Options

No matter which dental insurance plan you pick, you’ll want to get one that’s the best fit for you. And each dental insurance plan will have different conditions and features to consider. Some of these variables may include:

  • Network availability. “If you already know your dentist, it would be helpful to consider signing up for a plan that the dentist is in network with to maximize your benefits,” Kim said. A quick call can help you determine how a dental insurance plan will cover out-of-network services. Some insurance carriers will invite your dentist to join their networks if you request it.
  • Customer service. Speaking of a quick call, you’ll want to find a dental insurance plan with a strong approach to customer service. Whether it’s a call center ready to answer your questions or online resources, customer service can be a make-or-break for the dental insurance plan you pick.
  • When you’re getting dental work done, it can be tricky to determine actual costs until after the bill comes. Some dental insurance plans will let you check before you get the work done to get an estimate of how much of a procedure will be covered, and most dentists will work closely with you to get the full benefits and coverage allowed, Kim said.
  • Waiting periods. Some dental insurance plans require waiting periods for certain levels of service, especially major services, before you can access your benefits, while others are available almost immediately.
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