How Modern Dental Plans Work

There’s no denying the fact that dental work can be expensive—especially if major corrections are needed. If a person isn’t covered through their employer, they may be forced to buy their own coverage. Privately purchased dental insurance can be a significant drain on finances if one doesn’t buy a plan that suits their needs. Here, consumers can learn how to evaluate plans before making a decision.

A Brief Overview of the Dental Insurance System

Below is a description of how privately purchased dental coverage works. The buyer chooses a plan based on their budget and the list of dentists available.

  • If a person already has a dentist that’s in the company’s network, they can choose a less expensive plan.
  • If the person hasn’t chosen a dentist they can select from any practitioner that’s in the company’s network, and they can choose a cheaper plan.
  • If the person’s current dentist isn’t in the network they can still be covered, but out-of-network costs are higher. In some cases, the cost can exceed the amount a person would pay out of pocket.

Considerations to Make

Some may believe that those who have dental plans don’t usually come out ahead, and that’s a fair assumption to make. Insurers are in business to make a profit, and coverage is designed to protect the policyholder in an emergency. However, dental coverage is different; the downside is low but the benefits can be substantial. In years where only a standard cleaning and exam is needed, a person can lose several hundred dollars by having the coverage.

Will the Coverage be Available When it’s Needed?

In times where major dental work is needed, it’s not always best to have insurance. Most plans have low annual caps of about $1000, and once a person’s dental bills exceed that amount, they are responsible for the rest. Sometimes, patients can negotiate lower fees, but even those can be high.

Dental coverage rarely pays for costly procedures such as cosmetic dentistry and braces, even under the best of arguments. When they are covered, annual caps often prevent customers from saving much after annual exams and cleanings are factored in.