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Buying affordable dental insurance may not be a priority for most people. But it probably should be. In 2016, approximately 74 million Americans did not have dental insurance. Most health insurance plans don’t cover day-to-day dental needs, such as exams, fillings, and root canals. And although health insurance covers some extreme oral surgeries (such as jawbone restoration after a car accident), routine dental work is generally not covered.

Dental insurance plans are designed to bridge the gap. Whether offered by an employer or through a private insurer, most plans have monthly premiums, deductibles of $25 to $100, co-payments and an annual maximum benefit – the median is of $1,500.

A good argument for buying dental coverage is that many plans focus on preventative care. If cleanings and exams are free as part of your plan, you may be more likely to book and keep appointments. It can save you money and your teeth in the long run.

Key points to remember

  • Most health insurance plans do not cover preventive or routine dental care.
  • Before purchasing dental insurance, consider your care needs, whether your dentist is part of a network, and whether you want cosmetic services.
  • Dental benefit options include employer-provided insurance (sometimes with an FSA), Medicare Advantage plans, healthcare.gov and Medicaid plans, private dental insurance, and dental savings plans.
  • To get the most out of your policy, plan and schedule dental appointments in advance throughout the year to ensure the work is done before your benefit expires.

What are your dental insurance needs?

Here are some things to consider when estimating your family’s dental insurance needs for the next few years and what they might cost.

Do you have a dentist or hygienist you like?

If so, the best place to start looking for a dental insurance plan might be a conversation with your dentist or his staff. Find out which plans, if any, the firm accepts and if it is part of any networks. Also ask if the dentist participates in any discount programs or has an in-office plan.

Are you ready to choose a dentist from a list of networks?

You may be able to save money by choosing a dentist from a dental insurer’s network list. However, the cheapest plans offered by private insurers may have small networks, so check that there are dentists in your area who take any plan you are considering.Inasmuch asInasmuch as

What kind of care do you need?

Most plans generously cover preventative care, such as cleanings and checkups. To estimate the cost of dental care in your zip code without insurance, see Fair Health or Healthcare Bluebook.

If you receive regular care, your dentist can help you anticipate what you may need over the next few years. Expensive dental work, such as braces for a child or an adult, can cost anywhere from $3,000 up to $10,000 for complex cases. Dentures can cost thousands of dollars, and implants even more.

If you’re expecting these kinds of expenses, it’s worth researching which type of dental benefits can help you the most.

Can you wait 6-12 months for full coverage to kick in?

Plans often have waiting periods of up to 12 months before you are eligible for certain expensive benefits, such as braces or dentures.Inasmuch asIf you can wait, this type of policy could save you money. If you can’t wait, more expensive plans are available where the benefits begin immediately.

Do you want cosmetic procedures?

Cosmetic dentistry includes teeth whitening, veneers, gum lifts, and restorative fillings or crowns. Most dental insurance plans don’t cover cosmetic procedures, and plans that do may have a limited network and only pay a small percentage, like 20%, of the cost.Inasmuch asInasmuch as Dental discount cards, which offer discounted services from a network of dental providers, can be used for cosmetic procedures. (See below under “Dental Savings Plans”.)Inasmuch asInasmuch as

Dental insurance options

Your location and where you get your health insurance often determines which dental plans are available to you. Monthly premiums for individual coverage range from $20 to $80, on average. Private and employer-sponsored plans also have annual deductibles and annual maximum benefits of $1,000 to $2,000.

If the plan’s maximum benefit isn’t enough to cover your expenses, look for a plan with a higher maximum. Remember that pre-existing conditions are generally not covered by dental insurance plans. If you were missing a tooth before your coverage start date, for example, you may not be eligible for benefits.

Here are the main sources of dental insurance plans.

1. Workplace dental plans

Most Americans (77% in 2016) have dental insurance through their employer.Inasmuch asInasmuch as

This is often the most economical choice because the employer pays part of the premium. It is important to check the policy before registering, so as not to be surprised by the reimbursable costs. If a flexible spending account is available, consider using it for your share of expenses.

2. Flexible Spending Accounts (FSA)

Any dental visit or procedure that treats or prevents disease is eligible for FSA coverage (sometimes offered by employers with insurance). Cleanings, X-rays, crowns, dental extractions, dentures, gum treatments, etc. are included. However, cosmetic procedures, such as teeth whitening veneers or cosmetic orthodontics, are not. Your dental practice should be ready to help you ensure that the services are covered by your FSA plan.Inasmuch asInasmuch as

3. Medicare Advantage Plans

Most people with traditional health insurance do not have dental coverage. Nearly half of them have not visited the dentist in the last year and nearly 20% have spent more than $1,000 out of pocket on dental care. Traditional health insurance does not cover dental bills except those associated with serious conditions requiring hospitalization.

However, most Medicare Advantage plans offer at least dental coverage. Some plans only pay for preventative care, while others have more extensive coverage. Some Medicare Advantage plans charge an additional premium for dental coverage.Inasmuch asMany of AARP’s top Medicare Advantage plans include dental coverage.

77%

The percentage of Americans in 2016 who received dental insurance through their employer.Inasmuch asInasmuch as

4. Healthcare.gov and Medicaid

Under the Affordable Care Act, dental coverage for people under 18 is considered an essential benefit and must be available to your child. But dental coverage is not considered an essential benefit for adults. Some adult market plans include dental benefits. In some cases, the insurer offers separate, stand-alone plans for a separate additional premium.Inasmuch asInasmuch as

For children covered by Medicaid or the Children’s Health Insurance Program (CHIP), dental benefits are provided by the states. Some states also offer dental benefits to adults covered by Medicaid.Inasmuch asInasmuch as

Dental policies taken out by individuals

Insurance companies sell a variety of individual and family dental insurance policies online. You can choose a plan that only covers preventative care or a more comprehensive plan that also pays a percentage for expensive procedures such as root canals, bridges, and implants. When choosing a plan, check if there are dental practices in your area that are part of the network.

5. Dental Savings Plans

Often referred to as discount, savings or sponsorship plans, these are a membership club to reduce dental bills. The discount society contracts with dentists who agree to reduce their fees to members. The discount generally applies to all services, including cosmetic procedures.

To join a savings plan, you pay an annual fee which entitles you to reduced rates with dentists in the network, with no annual ceiling. Some dental practices offer their own internal discount plan with lower prices on services for patients who use this practice.

People who need little dental care — for example, just occasional cleanings and x-rays — can save money by using a discount plan rather than paying for dental insurance. People who have health conditions that affect their teeth and gums or who need major work can save more with insurance, if they can meet the plan’s annual limit. The best way to decide is to compare the costs of a discount plan versus a dental insurance policy for your personal situation.

The essential

Make sure you don’t leave money on the table: If you buy dental insurance or use an FSA, it’s a good idea to keep an eye on the key dates for using your benefits. According to the National Association of Dental Plans, only 2-6% of people covered by dental insurance plans reach their annual maximum. To get the most out of your policy, plan and schedule dental appointments in advance throughout the year to ensure the work is done before the benefit expires.

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