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Dental Insurance

How Dental Insurance Works

It is easy to think about dental insurance in the same way we think of medical or car insurance: basically, it’s a rainy day fund. It will just be one of those things that you don’t have to think about until you need it, right? Actually, dental insurance is more focused on helping people prevent dental issues rather than treating them afterward. This is why most plans will cover preventive care, such as routine check-ups and cleanings, 100% or offer a significant discount. Restorative procedures such as fillings or crowns can be covered up to 70%, and serious procedures such as implants or a root canal up to 50%. This is all meant to help minimize the cost of dental care so that it is more accessible to a wider range of people.

Types of Dental Insurance

Indemnity Plans: These plans work by paying your dentist for a portion of your dental care. The percentage for each type of procedure will be based off of the type of plan you are participating in. Other factors you should consider with these plans are co-payment requirements, possible waiting periods, deductibles, annual limitations, and the length of time you need to be on the policy before you can start getting dental work. 

Dental Health Maintenance Organization (DHMO): A dental insurance company will sign a contract with an individual dentist who will then offer a reduced cost of services to customers who have plans within the DHMO network. DHMO plans typical do not have waiting periods or annual maximums. Some plans even offer free or deeply discounted semi-annual preventive care. Restorative procedures such as fillings, crowns, implants, and dentures may have particular limitations.

Participating Network Provider (PPO): A PPO plan is very similar to a DHMO plan in thatin-network dentists will have a reduced cost. However, they also allow you to use an out-of-network provider as well. Any difference in pricing is then the responsibility of the patient, unless the plan dictates otherwise. These plans usually have an annual maximum that it will cover. These benefits also reset periodically, whether it be based on the calendar year, the fiscal year, or the date of enrollment with the plan.

A key thing all plans do is classify dental procedures according to categories set by the American Dental Association. Every procedure has a 3-digit code that specifies how it is classified, and this will directly reflect how your plan will cover it.

For Those without Dental Insurance

Many people do not have dental insurance, so their choice in dentist must come down to the one that can provide them the best care. While they may not be able to receive any assistance when it comes to payment, quality dental care in itself is a money saving proposition. Routine preventive care can save a patient from having to get more expensive restorative procedures. For patients who already need restorative procedures, an experienced and qualified dentist will save them time and money by completing the procedure with the least amount of visits possible. Do not let a lack of dental insurance impact the quality of care you receive, because cheaper care can often end up being more expensive.

Any Questions?

If you have any questions about dental insurance or what types of plans we work with, please give us a call today. We are ready to serve everyone in Lake in the Hills, IL despite what coverage they may or may not have.

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