How dental insurance works

How dental insurance works may be a little bit different from how other insurance works.

One of its prominent features is the waiting period associated with some of its plans. 

That is, you have to patiently wait for some time which may run into months or years.

Moreover, the waiting period depends largely on the procedure you wish to get on yourself.

You also have the choice of buying your dental insurance as a whole coverage on its own. Even though most people purchase it alongside their health insurance.

So, if your dental health becomes a concern to you and you want to know how dental insurance works, then, let’s get to it already.

What is dental insurance?

Dental insurance is the medical coverage plan that covers your oral health.

You can trace down a beautiful smile to proper oral hygiene. 

And a higher percentage of oral hygiene comes from dental care which in turn is covered by dental insurance.

Moreover, dental insurance makes the list of top expensive coverage you can buy.

If you’re lucky enough, you can get your insurance through your employer. If not, you have to buy your dental insurance privately.

What does dental insurance cover?

First and foremost, dental coverage pays for the cost of your dental care. 

While it takes care of your routine check-ups and dental cleaning, there are a couple of other things your insurance covers.

Your dental coverage takes care of root canals, fillings, gum health, oral surgery, dental crowns, and even oral x-rays.

More so, it covers dental bridges, implants, braces, and sealants.

However, your dental coverage is limited because there are procedures that your insurance can not cover.

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What does dental insurance not cover?

As expensive as your coverage may be and as advanced as you want to take your oral hygiene, there are some general limitations to dental coverage.

Some oral procedures will require you to pay for it out of your pocket and fully, too.

Take, for example, if you decide to whiten your teeth, your dental insurance will not cover it.

Also, as expensive as it may be, your coverage will not cover oral cosmetic surgery like veneers.

The reason is this, medically, these procedures are not medically important.

So, when you want to get veneers or whiten your teeth, make sure you have made plans for the payment.

How dental insurance works

Mostly, dental insurance covers a twice-a-year dental check-up. 

But for starters, read the policy your insurance company will provide to you when you shop around.

If you are lucky, your dentist will be in your preferred insurance company’s network. It may help reduce your coverage expenses. 

Compare policies and what they promise to cover. This is another important part of how dental insurance works.

Be sure to ask questions and understand where your insurance provider needs you to pay out of pocket.

Understanding the policy presented to you will help you tailor your oral need and know your expected deductibles.

Dental insurance can make you wait for a while before it kicks in. 

So, if you have an emergency oral issue and you did not start processing your insurance earlier, you may pay out of your pocket until your insurance kicks in.

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However, dental insurance does not cover preexisting oral issues.

Is dental insurance worth it?

How seriously you take your oral hygiene will help you to decide if dental insurance is worth it for you. 

Dental insurance is a personal decision you have to make by yourself.

If you decide that deductibles and co-pays are expensive, and do not mind paying for your dental check-up and procedure, it is up to you to make decisions.

But before you make such decisions, clearly understand that you can get dental insurance that covers fully all your dental preventive care.

How to group dental plans

If you decide to go for your dental insurance, you must patiently understand what applies and how to prepare for it.

Plans are grouped into 3 categories most times. So, do your thorough research to know where you fit in to.

Ideally, preventive dental plan procedures as stated above have 100% coverage from your insurance company. Preventive plans include teeth cleanings, and x-rays.

Basic dental plan procedures like canal fillings have up to 80% coverage. 

Your insurance company covers 50% of the major dental plans.

Finally, there’s the full dental insurance that covers 100% of your preventive care and a little of basic and major plans.

Dental coverage and networks

Dental insurance deals with a network of dentists willing to offer their services at a discounted rate.

More so, these dental plans and their networks differ from each insurance provider.

What your network provider agrees to cover may not be the same as the next.

Dental Health Maintenance Organization 

This organization is made up of dentists that came together and agreed upon a collective rate for your insurance coverage. 

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Getting this insurance, you will only go to the dentists for your dental issues. However, it is quite beneficial to the policyholders.

Preferred Provider Organization (PPO)

The Preferred provider organization gives you the choice of choosing a dentist within the in-network of dentists available under the organization. 

Because of the large in-network of dentists, you can get plans with relatively low deductibles and may not experience any waiting period at all.

Dental insurance waiting period

While we discuss how dental insurance works, we can point out the waiting periods too.

This is the period you have to patiently wait until your insurance starts working.

Now, your preventive dental plan does not require a waiting period. 

So yes, your insurance kicks in right away and you can take your oral hygiene to the next level.

Furthermore, if you buy the basic plan, you may have to wait for months before your insurance becomes effective. As it stands, you may be waiting for as long as three to six months.

Also, this goes for major dental plans. This plan keeps you in the waiting period for possibly a year. If you’re lucky, six months.

In conclusion, how dental insurance works may differ according to location and insurance provider involved. 

More so, dental insurance is just as important as your other insurance plans. 

If you care about your dental hygiene, consider buying dental insurance. 

It will help you confidently smile from ear to ear.

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