Part 1: What is Dental Insurance, How it Works, Types of Dental Insurance, What is Not Covered
Part 2: Why is Dental Insurance Important, Where to Buy it, Cost, Things to Keep in Mind, Should You Have Dental Insurance
Introduction to Dental Insurance for Kids and Teens
This video explains the concept of dental insurance in a simple, concise way for kids and beginners. It could be used by kids & teens to learn about dental insurance, or used as a money & personal finance resource by parents and teachers as part of a Financial Literacy course or K-12 curriculum.
Suitable for students from grade levels:
- Kindergarten
- Elementary School
- Middle School
- High School
The topics covered are:
- What is dental insurance
- How does dental insurance work
- What are the types of dental insurance
- What’s usually not covered in dental insurance
- Why is dental insurance important
- Where to buy dental insurance and how much does it cost
- What to keep in mind when choosing a dental insurance plan
- Should you have dental insurance
What is dental insurance?
Dental insurance is a contract with an insurance provider to help cover a portion of the cost of dental care for individuals and families, including regular check-ups, cleanings, x-rays, and various procedures.
Many insurance plans provide 100% coverage for preventative care like bi-annual cleanings, routine x-rays, etc., 80% coverage for basic procedures like filling, root canal, etc., and 50% coverage for major procedures like implants, surgeries, etc. However, the exact coverage varies depending on the individual policy.
Dental insurance is usually not part of regular health insurance, although it might be an optional add-on.
How does dental insurance work?
Dental insurance is very similar to health insurance. You pay the insurance provider regular premiums in exchange for them sharing the costs of dental care.
In addition, you may have to pay deductibles, copays, coinsurance, etc.
Deductible is the minimum amount you need to pay before insurance kicks-in. For instance, if the deductible is $100 and the dental procedure costs $80, insurance will not pay anything.
After the deductible is met, you may have to pay a percentage of the covered procedure, which is called co-insurance. This can range anywhere from 20% to 80%.
Or you may have to pay a fixed dollar amount, called copay.
The rest is paid by the insurance provider up to a predetermined annual maximum amount.
Dental plans either have copay or coinsurance – not both. HMOs usually have copays and PPO plans usually have coinsurance.
As with health insurance, visiting an in-network dentist will mean you pay less. If you end up going to an out-of-network dentist, you will pay higher deductibles, copays and coinsurance.
What are the types of dental insurance?
Dental insurance plans generally come in three main types:
- Health Maintenance Organization (HMO) Plans have lower premiums and out-of-pocket costs compared to other plans, but offer less flexibility. You are required to only visit in-network dentists, and services outside the network are usually not covered.
- Preferred Provider Organization (PPO) Plans typically have higher premiums and out-of-pocket costs as compared to HMO plans, but offer more flexibility. You can use in-network dentists who charge lower fees, or go outside the network and pay more.
- Indemnity Plans, also called fee-for-service plans, offer the most flexibility since they allow you to see any dentist. The insurance company pays a set percentage of your total cost and you pay the rest. These plans usually have higher out-of-pocket costs and premiums than the other two.
What’s usually not covered in dental insurance?
Exclusions vary across dental insurance policies, but in general they don’t cover procedures that aren’t deemed medically necessary. For example, cosmetic procedures like teeth whitening or orthodontic treatments like braces.
Also, some plans have waiting periods for major procedures, meaning you have to be enrolled in the plan for a certain amount of time before coverage begins for these services.
In addition, there is usually an annual benefit limit, meaning the plan will only pay up to a certain amount each year.
Why is dental insurance important?
Dental care can be expensive, and having dental insurance can save you money by covering part of the cost. It can also help reduce the cost of unforeseen or expensive major procedures.
Maintaining good oral health is important and by getting preventative care that’s covered by dental insurance, you are more likely to detect problems before they become serious.
Where can I buy dental insurance? And how much does it cost?
Many employers offer dental insurance, where the premium is deducted from your paycheck.
If your employer doesn’t offer dental insurance, you can purchase individual or family dental insurance directly from insurance companies, insurance brokers, or insurance marketplaces.
But dental insurance is usually less expensive when bought through an employer.
Depending on your age, location and the plan you choose, the premium can range from $20 to $50 per month for one person.
The premium per person is lower if multiple family members are covered under the same dental plan. The premium is also lower in plans with higher deductible, copays and coinsurance and vice versa.
What should I keep in mind when choosing a dental insurance plan?
When choosing a plan, you first need to know what dental services you use and how much they cost.
For example, if you are prone to teeth or gum issues, you’ll be spending more on fillings, extractions, etc. This can help you decide what type of policy to buy.
When comparing policies, it’s essential to look at what is covered, the annual limit, the network of providers offered and whether your preferred provider is in the network, and your out of pocket cost: premium, deductible, copay, and coinsurance.
Should I have dental insurance?
That depends on your personal situation – oral health, age, anticipated treatments, etc.
If you spend a significant amount on dental care and can find an inexpensive plan, dental insurance will likely save you a lot of money.
But if you don’t spend a lot on dental care, you might be better off just paying out of pocket when necessary.