Visiting the dentist regularly is crucial to keeping your mouth healthy and your teeth shining brightly. But those visits can get pricey on their own. Fortunately, many employers offer dental benefits that can alleviate the financial burden of oral care. If your company’s open enrollment is approaching — or you’re just planning ahead — and it’s time to select a plan, you may be overwhelmed by the various options and dental insurance terminology. Take your time to understand the options and make the best decision for your circumstances; here are some factors to consider during the process.Cost
Let’s first address the factor you probably care about most: cost. Dental plans have service classes that dictate how much your insurance covers for specific procedures. These classes are diagnostic and preventative (e.g., teeth cleanings and X-rays), basic (e.g., fillings and root canals), major (e.g., crowns and dentures), and orthodontic (e.g., braces). Diagnostic and preventative services are often covered in full, meaning there will be no out-of-pocket costs. Major and orthodontic services are typically the most expensive out-of-pocket procedures.
You should also factor in premiums and deductibles. A premium is the amount you’re required to pay the benefits company for dental coverage, usually on a monthly basis. Your employer may cover a portion of this cost, and anything you owe can come directly out of your paycheck. Typically, the higher the premium, the higher the level of coverage for basic, major, and orthodontic services. A deductible is what you’re required to pay for dental services before your benefits provider will pay. If your plan also covers members of your family, you’ll have a family deductible.
Think about your dental needs, as well as those of family members who will be on your plan. Do you have children who need braces or play sports that bring a higher risk of mouth injuries? Does anyone have a history of dental issues (e.g., gum disease, tooth sensitivity, cavities) or need major dental work, such as a crown? These circumstances may require a more comprehensive plan with a higher level of coverage for basic, major, and orthodontic services. On the other hand, if you are single and maintain good dental health, a basic plan may be all you need.
After you determine which plan(s) will fit in your budget and what you and your family need, dive a bit deeper and examine any limitations in coverage. Dental plans usually have an annual maximum, which is the most amount of money your insurance will pay in a policy or calendar year. While many people don’t go over the limit, it’s important to factor it in if anyone in your family has ongoing dental issues or needs major procedures like dental implants. Also, consider whether your current dentist is in-network or out-of-network. In-network providers are typically more cost-effective to visit, but a plan with a strong MAC or UCR can help you visit an out-of-network dentist affordably. Additionally, certain procedures, such as teeth whitening, may not be covered.
While choosing a dental benefits plan is important, it doesn’t have to be difficult. By learning more about your options and asking questions during open enrollment, you can make the best choice for your situation.