How to Choose a Dental Insurance Plan

A Insurance Article Contributed by Shobha Cutting

How to Choose Your Dental Insurance Plan

While the limits and exclusions, together with the premium, are important considerations in your deciding on the appropriate dental insurance plan, they are not the only factors to look at when choosing your plan. You should evaluate whether or not that particular plan will meet your needs as far as dental care goes. Please take the following into consideration:

Does Your Dental Insurance Plan Allow You to Choose Your Dentist?

You may be satisfied with the service that you get from your family dentist and changing the dentist may negatively impact your dental health. Dental care is based on preventive treatment. Your visits to your dentist may become less frequent because you may not be at ease with your new dentist. Trust and understanding are important in a doctor-patient relationship. Don't let an insurance policy prevent you from seeking advice and treatment from the professional that you trust.

Who Controls Treatment Decisions - Your Dentist or Your Dental Insurance Plan?

Many dental insurance policies require that your dentist rely on the 'Least Expensive Alternative Treatment' (LEAT) approach. If there are multiple treatment options available for your condition, some insurance plans will pay only for that treatment which was the least expensive option. Should you or your dentist choose the option that may be more suitable in terms of your long-term dental health, even if not the least expensive, you will bear the difference in costs. The cost reducing measures may adversely affect your dental health in the long run.

Does Your Dental Insurance Plan Cover All Diagnostic, Preventive and Emergency Services?

Most plans provide for dental care, together with diagnostic, preventive care and emergency treatment that is necessary for maintaining good oral health, on average. But the limits placed in some dental insurance plans on the extent and the frequency may restrict their use and be insufficient, depending on your individual circumstances. Every plan is different. You must pick the plan that suits you.

Routine Corrective Treatment - How Much is the Policyholder Expected to Pay?

Whereas preventive care diminishes the need for serious disease, it does not guarantee optimal dental health. Being disease-free is different to being in the optimal dental health, for which some extra treatment may be required. Such treatment can be categorized as routine. In most plans, 70 to 80% of such routine treatment is provided for.

It is important to note what routine dental care is covered by the plan, and what percentage of the costs will come out of your pocket.

Major Dental Care - What Part of Costs is Payable by the Policyholder?

Since dental insurance plans pay for preventive treatment and most major dental care is avoided by prevention, some dental insurance plans are not generous when it comes to reimbursing major dental treatment. There are limitations and most plans cover less than 50% of such costs. Be aware of these restrictions. You and your dentist are best suited to decide the appropriate treatment- preventive or otherwise.

What about Specialist Care?

Some dental insurance plans may limit your visits to specialists. Or, your dentist may be asked to refer you only to a selected set of specialists. You may be required to obtain prior approval from your administrator for seeing a specialist. Discuss these options with your dentist before finalizing the plan.