How to Choose the Right Dental Insurance Plan

Medical forms with stethescope

It’s that time of year again, when many new high school and college graduates begin entering the workforce. Accepting a new job at any age or career level can be an overwhelming and stressful time, especially with all that new hire paperwork. As daunting as it can be to figure out how much tax to withhold, selecting a dental insurance plan can be even more confusing. How do you know if you’re choosing the best plan for yourself and your family? How much coverage is too much coverage, or not enough coverage? If it’s time to select a new dental insurance package but you’re not sure what to choose, here are some tips to help you get the best coverage for your money.

  • Ask your dentist

    If you already have a dentist, call the practice and ask which insurance plans they accept, and which plans or insurers they recommend. A practice may accept insurance from some providers but may cringe at the idea of dealing with them. Furthermore,  some dentists within the same practice may accept different insurance plans than others, so make sure that you’re getting the right plan for the right provider.

  • Use your age as a factor

    If you are young, single, child-free, and have good oral hygiene, you may not need the most comprehensive package available. You still need to meet a minimum of coverage and should look for plans that at a minimum include:

    • Two exams / cleanings per year
    • Annual X-rays
    • Fluoride
    • Sealants
  • Compare plans online.

    Most employers will give you a few days to mull over your options before deciding which plan you want. Take that opportunity to go home and see what else is out there, and at what cost. You may be able to find a less expensive plan on your own, or one that offers better coverage for roughly the same price.

  • See who’s available in-network.

    Your insurance company should provide you with a list of in-network dentists. Call around and see if those dentists are accepting new patients, and how far out they’re booking. An insurance plan is not going to help much if nobody who accepts the plan is accepting new patients.

  • Verify that your dentist is in control

    . With some plans, you may be required to receive preauthorization from your insurer before being treated. This means if you break a tooth or need a root canal, you could be waiting weeks for someone who has never met you or seen your teeth to decide whether your procedure will be covered. Don’t put yourself through the unnecessary pain of delaying emergency dental care. Look for a plan that allows your dentist to treat you without prior approval.

  • Crunch the numbers.

    Review your finances and make sure you can afford the copays and the premiums and maximum allowance. If you already have some idea of how much you spend a year in dental costs, make sure your premiums don’t exceed that amount.  Most plans cover up to $1,500, leaving anything above that amount up to you to pay out of pocket. If you think you will require more than your plan’s maximum allowance, look for a plan with a higher max, but keep in mind these plans may come with a higher copay.

Ideally, plans should cover appliances such as bridges, crowns and implants at 50 percent, leaving the balance as the patient’s responsibility. Procedures such as fillings, extractions and root canals should be covered at the 80 percent level, leaving you responsible for 20 percent of the cost.

A nice perk to have is a plan that covers orthodontic work. Most insurance plans with this type of coverage have a lifetime maximum, meaning once you’ve met your maximum the plan will not cover more, even if you require additional treatment years later. This is why it’s important to wear your retainer!

If you have any questions or concerns about your current dental insurance plan or would like to know if Dr. George’s office accepts an insurance plan you are considering, please give us a call at 724-934-3422.

Dr. Alexandra S. George

Medically reviewed by Dr. Alexandra S. George - D.D.S., L.Vl.I.F. on June 27th, 2017