What are the potential out-of-pocket costs associated with the dental plan?
Aside from the monthly premium and copayments, many dental plans require you to meet a deductible before covering part of your treatment costs. Insurers may also have a maximum annual allowance per 12 month period, which means they will not cover anything outside of this amount.
If you think you need procedures or treatments not covered by your plan, or prefer to use an out-of-network dentist, these factors will likely increase your out-of-pocket expenses.
Which dentists are part of the network?
If you want to stay with your current dentist, ask what insurance plans he accepts. Some dental insurance companies have an extensive network of providers, while others may require you to switch to an in-network provider in order to obtain coverage. When considering an insurance provider, check to see if dentists are available in your area to keep your costs down.
What does the plan cover?
Consider your current and future dental needs when comparing dental plans. Preventative services are generally covered and include exams, x-rays, teeth cleaning, fluoride treatment and sealants. Although not all plans cover orthodontic coverage, some include coverage for children, so read the plan details carefully when making your selection.
Does coinsurance start low?
Coinsurance is the percentage you pay out of what the plan pays. Some plans have graduated benefits that increase insurance reimbursement over two or three years. This can leave you with a low level of coinsurance in the first year. And if you don’t stick with the plan for a few years, you won’t achieve the best repayment levels. We prefer plans with a good level of coinsurance from the start, because you never know when a major dental problem will arise.