What Do Dental Plans Cover?
Stand-alone dental plans typically cover the following services:
- Preventive care, including regular cleanings and exams
- Diagnostic procedures such as X-rays
- Basic procedures like fillings
- Major procedures such as crowns and root canals
- Some plans may also cover specialized procedures like periodontics and endodontics
Please note that the specific coverage can vary greatly between different stand-alone dental plans. It’s important to review the details of any plan before enrolling.
Dental Insurance FAQ
What should I do before choosing a dental plan?
Before choosing a dental plan, it’s important to educate yourself about the different types of dental insurance and how they work. Consider reading introductory articles about dental insurance and ways to lower your annual dental insurance costs.
Should I buy dental insurance?
Quality dental insurance encourages regular dental visits and promotes good oral health. Regular checkups also allow dentists to screen patients for symptoms related to more than 120 different non-dental diseases, including diabetes and heart disease. It’s recommended to shop for a plan that covers preventive, minor, and major dental care with reasonable out-of-pocket costs.
What is a PPO dental plan?
A Preferred Provider Organization (PPO) is a type of dental insurance plan in which enrollees select their dentist from a network. Enrollees may use an out-of-network dentist but risk higher out-of-pocket costs. PPO dental plans may help contain patient costs but also restrict access to some services.
What is a DHMO?
A Dental Health Maintenance Organization (DHMO) is a form of dental coverage where dental services are delivered through a network of dentists. The dentists within the network receive a fixed monthly fee per patient. HMO dental insurance is often the least expensive dental plan option and it lacks a “maximum benefit.”
What is a discount dental plan?
Discount dental plans are fee-based membership programs allowing enrollees to obtain dental services at discounted rates from a group of dentists who belong to the discount plan’s network. These plans are not insurance products. The patient pays directly for care instead of the dental plan, but the dental care is received at a discounted rate.
What is a maximum benefit?
A maximum benefit is the cap on insurance company payments toward covered dental services during a year. Expenses exceeding the maximum benefit amount are paid completely by the patient.
What the plan type is right for me?
Before choosing a plan, consider your dental health needs, budget, and the level of flexibility you want in choosing a dentist. It’s also important to read the plan details carefully to understand what services are covered, what the out-of-pocket costs will be, and whether there are any waiting periods for certain procedures.