As an insurance broker, we’re often asked if dental insurance is worth the expense. A typical dental plan premium (the fixed amount you pay monthly) will cost between $20-50 per month; and whether or not it makes sense will likely depend on the following factors:
Do you regularly go for preventive care? Most dental plans will cover 100% of your preventive care if you visit an in-network dental provider. Preventive benefits will typically cover exams, cleanings, x-rays and fluoride treatments for minors. If you regularly go for your preventive care, the cost of dental insurance can pay for itself.
Is your dentist in-network? If your dentist is in-network with your dental plan, you will generally have lower out of pocket costs for your dental care. For example, your preventive care is usually covered 100% if your dentist is in-network, but you may be responsible for excess charges if they are out-of-network.
Over the years we have seen a trend with more dentists choosing to no longer accept dental plans as an in-network provider, and instead accept PPO dental plans only as out-of-network providers. This can be confusing for consumers because they’re often under the impression that they’ll receive the same coverage - but they can be subject to higher out of pocket costs when receiving care.
If your dentist is in-network with your dental plan, or if you’re willing to switch to an in-network dentist, dental insurance can make more sense and offer more value.
Dental Preferred Provider Organization (PPO)
With a dental PPO plan, the insurance company has negotiated contracts with a network of dentists that have agreed to charge set fees for approved services. Patients will typically receive lower out-of-pocket costs if their dentist is in-network, and will also have the flexibility to use out-of-network dentists (generally at a higher cost). Dental PPO plans are the most common type of dental policy
Dental Maintenance Organization (DMO)
A DHMO typically offers a lower monthly premium with an emphasis on preventive care. Patients are required to choose a primary dental facility or clinic to coordinate and manage their dental care. If there is a need for a specialist, the primary provider will be required to submit a referral. DHMOs do not offer coverage from out-of-network dental providers.
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Not connected with or endorsed by the United States government or the federal Medicare program. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-medicare to get information on all of your options.