Dental insurance can be very hard to understand, but that doesn't necessarily
mean that it it is worthless. In order to get the most benefits from dental
insurance you will need to understand how it works
As always information is key in this video I will explain how to benefit from
dental insurance and I will try to address such questions as how does the
dental insurance work? what is the best dental plan? what is the difference
between the dental PPO and HMO plan? what is a waiting period?
how much does dental insurance cost? am i required by law to have dental insurance?
also I will address and that such topics as individual versus group dental which
one is better what is covered by dental insurance what's the difference between
in-network and out-of-network here all of this information will help you decide
if dental insurance is worth the cost please watch this video until the end as
I will give out helpful tips and tricks that will help you get the most benefits
out of your dental insurance also feel free to check out a side-by-side
comparison comparison of various dental plans and the case study that I will be
posting in the description section under this video ok so let's get started how
does dental insurance work if you've had health insurance you are going to be
very familiar with how dental plan works if you are still confused I'll explain
how it works usually pay a premium every month it's a certain amount monthly to
buy the dental insurance plan your insurance won't pay for everything so
there are few things you might want to know like deductibles coinsurance and
co-pays what is that your deductible is what you have to pay out-of-pocket for
services covered by your plan before the insurance company pays your plan may
include co-pays this is a fixed cost you pay for a certain service like for
example an x-ray coinsurance refers to the percentage you pay for
covered expenses of Tanith your deductible so if your coinsurance for a
filling is 20% and the cost for that service in network
is $100 you would pay $20 for that the insurance company would pay for the rest
of your college expenses up to your annual maximum how much does dental
insurance cost well the answer is it depends the HMO plans tend to be less
expensive and PPO plans are a bit more pricey before buying dental insurance
first ask yourself what are your needs to the map
often your annual premium is less than the cost of two visits to your dentist
for a year for regular check-ups you can call your dentist and ask for the price
of a visit if you pay yourself without insurance it's likely that dental
insurance is cheaper than paying for two visits out of your pocket plus you get
the added benefits of having dental coverage that will save you money in
case of unexpected dental issues that could come up under this video I will
have a sample comparison of various dental plans available in California so
feel free to check it out by the way comparing the dental benefits
side-by-side is a great way of determining what type of plan would
benefit you the most there are some discount plans for as low as seven
dollars a month obviously PPO plans range from a bit more pricey and range
from like $35 to $80 a month the comparison is for information only and
it's based on California zip code for individuals and families next am i
required by law to have dental insurance the answer is no the Affordable Care Act
doesn't legally require adults to have dental insurance however having dental
coverage is an important part of staying healthy and having access to preventive
dental services it is up to you whether you decide to buy dental insurance but
choose to pay the full cost of dental care out of your pocket what is covered
by dental insurance here is the typical breakdown of dental benefits categories
major it's usually covered at 50 percent which means them
with paying 50% for the most of the time crowns bridges dentures partials inlays
onlays etc are considered major procedures basic usually covered at 80%
which means that insurance or the patient pays the other 20% most of the
time fillings extractions para dontel services root canals core build buildup
filling and root planning are considered basic preventative usually covered at
hundred percent which means that in short or the patient pays nothing
additional most of the time routine cleanings like x-ray exams dental
sealants it's Azra are considered preventative there are usually timing
limitations to the cleanings and sealants so this are different in almost
every policy check on that alright and in addition I would like to outline one
very important aspect of dental insurance most individuals and family
dental plans have a waiting period for basic and major services group plans or
employee benefits plans usually don't have a waiting period due to various
reasons due to the risk of adverse selection the insurance companies can
put and pose a certain a waiting period for the individual dental plans for
example some contracts will not let you get any basic services in the first six
months of the policy and you might have to wait as much as 12 months in order to
get major procedures covered there are some exceptions and I will have one of
those plans in my comparison chart that I will post under this video now that
you understand the basics of how dental insurance works let's talk about the
types of dental insurance plans which is another area that can be totally
confusing and can change each time you renew your health insurance if your
dental insurance is part of that plan it can change yearly and this can
determine how much out-of-pocket you pay so let's explore various types of dental
insurance and try to determine what is the best plan for you
there are three basic types of dental insurance plans dental HMOs dental PPOs
and dental indemnity plans to find the best one for you you should consider
what your most important deciding factor saw for example cost keeping your
dentist flexibility and so on and look at dental plans that suit your needs
let's look at the key characteristics of the three basic types let's start with
the dental HMOs HMO stands for health maintenance
organization if you participate in a dental HMO you generally have lower
premiums than either a dental PPO or an indemnity plan no annual maximum - the
benefits that the plan will pay a restrictive network of dentists and
dental providers no benefits for going to out of network dentist or providers
and a list of co-pays which is a standard cost you will spend for office
visits and specific dental services let's take a look now at a dental PPO
plan PP o stands for preferred provider organization if you choose a dental PPO
plan you can expect higher premiums than a dental HMO and annual maximum - your
benefits for example at $1,000 per year maximum or $2,000 per year max but it
varies by plan and network of dentists or providers that have agreed to offer
discounted services and you can choose to use to save money to choose those
doctors some benefits paid to out of network dentists - all providers you
might choose to go instead a list of percent the insurance company will pay
for different dental services for example many dental PP o--'s cover a
hundred percent of preventive services as I mentioned earlier like exams and
cleanings that may pay only 50% for major expenses like crowns or bridges
now let's take a look at dental indemnity plans this is a traditional
fee for service insurance offering the most freedom of choice you can expect
higher premiums than either dental HMO or dental
video and annual maximum cheer benefits as small deductible you have to meet no
network of providers meaning you get the same benefits with any dentist you
choose but also meaning there are no Network negotiated discounts or dental
on dental services which means you can pay a little bit more you could pay more
a list of the percent the insurance company will pay for different dental
services just like the dental PPOs as I mentioned earlier I will have a link to
my blog with a side-by-side comparison of these plans you can compare various
plans and also see the cost of dental insurance for each of the plans now
let's take a look at a very important AXA aspect of dental insurance and find
out what is the difference between in-network and out-of-network dental
care in network care means that you can only see the doctor or doctors that are
in network or have a contract with your insurance company out of network means
that you can go to other doctors but you will have to be extra careful and don't
assume that because you will end up paying more for out-of-network care here
are few things to keep in mind cost and convenience you can help make it more
affordable dental care for yourself by staying staying in-network a dentist in
network has agreed to lower rates on services and this could benefit you also
some dental insurance plans don't pay any benefits to out of network dentists
at all or pay less check your plan before you buy finally if you stay
in-network you often won't have to deal with submitting claims yourself the
dental office and your insurance provider will handle that on your behalf
if you are out of network you may have to submit your own claims and wait to be
reimbursed again before you buy a dental plan I will highly advise that you
search whether or not your doctor is a network or find another doctor that
works with your insurance company now as I promised in the beginning of this
video here is a great information that will help you navigate the dental
insurance needs first pay attention to when you are
buying the insurance if you are at work and the employer is offering multiple
plans spend some time really researching which point is best for your family
or for yourself if you really only need dental cleaning then maybe a basic
dental plan will be sufficient if you are planning a major procedure like a
root canals crowns and said etc but then you may want to get more expensive plan
that pays more for this procedures and is less likely to exclude services also
call your insurance company and ask questions remember you are paying the
money so ask the question soon try to understand your plan also read the
booklet that you get from the insurance company it is ultimately your
responsibility to know how the plan works so do your homework read the
summary of benefits for your plan believe me this will save you tons of
money work with an insurance agent agents will be able to compare various
options and help you choose the one that is best for you if you don't have an
agent we will be glad to help you we are in California get a treatment point from
your dentist this is a great way of estimating what dental work needs to be
done when it needs to be done and how much it will cost you do the math call
your dentist office and ask how much did we spend a total aside from insurance
last year if this amount is less than you insurance premium maybe you should
just pay out of your pocket or utilize an HSA how savings account it really
doesn't make sense to pay more for insurance then you get in benefits year
after you again do the math it will help you make the right decision
in case there are other tricks that you might want to share with the world feel
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you