Dental Insurance 101: Everything you need to know.

July 05, 2021 | Althea Kelsey | Online Courses

Dental Insurance 101: Everything you need to know.

We have always said that we should brush our teeth regularly morning and night because our oral health is a good indicator of overall health. For the sake of a good smile, it is also important because it prevents us from 120 types of critical diseases like stomach diseases, heart diseases, diabetes, etc. To avoid such diseases, it would help if we visit our dentist regularly. A routine checkup can keep us alert before starting the cavity.

Cue Dental Insurance
Cue Dental Insurance

But even we are too lazy to brush regularly; that is why according to the research by the Centers for Disease Control and Prevention research, probably 27 percent of adult Americans are suffering from untreated cavities, and more than half suffer from gum diseases. In this situation, a good dental plan can benefit your good smile and help your wallet as well because a casual dental checkup can be worth more than 100$. On the contrary, dental insurance can offset the high cost of dental care. Cue dental insurance is like health insurance and helps us with dental costs. Yet, we are also too lazy to visit our routine checkup because 57 percent of people skip their routine checkup, according to the American Dental Association.

However, it is important to have knowledge about some policies to get most of the benefits. Here we will try to cover the basic questions.

How does dental insurance work?

Cue dental insurance provides us a portion of the cost and related services. A dental insurance plan lets you choose one option out of three. These options cost differentially and provide services according to the plan, which is followings: – 

Preventive dental care or 100% Coverage.

This option covers whole dental issues from major to minors and provides preventive services. It will cost you 100%. It is a specific category of dental insurance which includes the following services.

  • Regular oral examination.
  • Fluoride treatment to age 14.
  • Bitewing x-rays
  • Oral evaluations and cleanings twice per year
  • Brush biopsy
  • Sealants: Plastic tooth covering to prevent decay
Dental Insurance
Dental Insurance

Basic Dental Care or 80% Coverage.

This plan covers 80% coverage and provides services. These services are counted as basic services. It will provide the following services: –

  • Regular Visits
  • Filling
  • Radiographs/diagnostic imaging
  • Extractions
  • Emergency palliative treatment
  • Periodontal treatment for gum disease
  • Root Canal
  • Minor restorative services 

Major Dental care or 50% Coverage.

This plan includes 50 percent coverage of dental treatment or less, which are major dental diseases. It will provide only major services, which are followings: –

  • Denture and bridge repairs
  • Prosthodontic services
  • Crowns
  • Dental surgery
  • Cast restorations
  • Periodontic services
  • Relines
  • Inlays: Something between a filling and a crown
  • Note: Some dental insurance plans include root canals under the “major” dental care section, but some categorize them under the “basic” section. However, the cost of “major dental care” is a bit higher, and most insurance plans cover about 50% of the fee.
Dental Plan
Dental Plan

Dental Insurance Plans:

Basically, there are two types of dental insurance plans.

DMO Dental Plan:

Dental Maintenance Organization is one of the most affordable programs. It covers 100 percent preventive care. It is non-deductible and only set fee in non-preventive dental services, but all dental providers usually charge less than usual fees. It is the most helpful plan because it allows you to visit any dentist under the network list. This plan works better and costs less if you use the services from the dentist under the list of networks. It is a monthly premium plan. Therefore, it usually costs a bit more than the regular. If you do not have any cavities, then DMO will be the best option for you.

DMO Dental Plan
DMO Dental Plan

PPO Dental Plan:

The Dental Preferred Provider Organization plan is one of the most popular plans which provides fixed monthly premium plans, but usually, these plans have an annual deductible and coinsurance. With this plan, you can visit any dentist under the list provided by the PPO network. You can also use outside services, but they will cost a bit more. If you have used all the services before the end of the year, then these plans start charging you as per service.

Dental insurance services and plans can vary, So, it would be better to compare different plans and choose the most suitable one.

PPO Dental Plan
PPO Dental Plan