Dental Insurance Plans — Coverage For Dental Care
Having dental insurance enables you and your family to get necessary dental procedures like checkups and cleanings, so your teeth and gums are in good health. Good dental health is important so you can stay pain-free, and avoid expensive emergency procedures.
McGregor Benefits is an independent health insurance agency in Washington state, here to answer all your questions about dental insurance.
What Is Dental Insurance?
Dental Insurance is coverage for the health of your teeth and gums. Individual dental insurance covers preventative care as well as treatments. Different plans have different costs and coverage options.
What’s Typically Covered
Essential dental work and maintenance is all that is covered under most dental plans. This includes
- Basic dental procedures – such as x-rays and fillings.
- Major dental procedures – such as crowns and bridges
What Is Not Typically Covered
Cosmetic procedures such as teeth whitening and veneers are not covered in most plans.
Dental insurance isn’t usually a part of health insurance. Some health plans may include dental coverage, but most of the time you’ll need a separate plan for dental care.
Comparing Dental Insurance Plans
The largest dental insurance company in Washington State is Delta Dental. They offer comprehensive and cost-effective coverage, and are accepted by most dentists in Washington. Delta Dental has 5 individual plans and 3 family plans to choose from.
Individual Dental Plans
Delta Dental offers a great selection of private dental insurance plans for Washington state residents.
This is the least expensive dental insurance plan you can buy. It’s a great choice for most health individuals who need basic dental insurance to cover preventative care and fillings. Expect to pay a low monthly premium and a small copay each time you visit the dentist. Cleanings, exams, x-rays, and fluoride are typically 100% covered under this plan. If you need fillings, expect to pay ~50% of the cost out of pocket. Most other dental procedures are not covered under the Basic Plan.
This plan is slightly more expensive than the basic plan in terms of monthly premium. Office visits typically don’t have a copay, however expect to pay coinsurance (a percentage of the cost) for each service. This plan will cover the majority of costs of preventative services, as part of the costs of more advanced dental procedures. If you expect to need more than just fillings, this plan be a better choice for you. The other benefit is a monthly contract, compared to annual commitments for most other plans.
This plan is designed for those ages 51+ needing more comprehensive dental care. Advanced procedures can be expensive and the out of pocket costs are usually unpredictable. This plan helps by providing fixed out of pocket costs for most major procedures.
Consider this an upgraded alternative to the Classic plan. Expect cost sharing for all major dental procedures and restorative services. Preventative care is usually completely covered, and there’s no office copays.
This is the most comprehensive dental insurance plan available. One of it’s highlights is a plan year maximum out of pocket that’s nearly twice that of the other plans. Cost sharing applies for all major procedures, but the plan covers the majority cost of fillings. Expect to pay a monthly premium close to twice that of the Basic Plan. This is a lucrative option for those needing frequent and/or extensive dental procedures.
Family Dental Plans
For families of 3 or more, family dental insurance plans are a smart option to get great coverage and protection from unforeseen expenses.
Clear Family Plan
Similar to the Clear individual plan, this insurance plan provides fixed out-of-pocket costs for all preventative and major dental procedures. It doesn’t have any waiting periods to enroll or any office copays. Since you pay a fixed amount for each service, there’s no plan year maximum to worry about. An affordable and predictable dental plan the whole family can count on.
Family Advantage Plan
The Family Advantage plan is a great option for those needing routine preventative services and the occasional filing or procedure. This plan has no office copays and covers preventative services entirely. Cost sharing applies to everything else. This plan has a shared maximum benefit per person, so consider that when deciding.
Similar to the individual Premium plan, this is the most comprehensive plan for families. It has a very high yearly maximum per person, which makes it a more enticing option than the Family Advantage plan if one or more family members require more extensive dental services.
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All you pay for is the premiums, which are the same with or without our help.
How Does Dental Insurance Work?
In order to get it, you will need to contact an insurance agent. They will help you choose a plan based on coverage, cost, and providers. If your preferred dentist is part of the plan’s network, you’ll have to pay a lot less. Individual dental insurance costs around $50 per month, and you will have a deductible, and coinsurance as well.
Types of Dental Insurance
There are two main types of dental insurance plans:
Dental Health Maintenance Organization (DHMO)
In a DHMO plan, you need to see a dentist who is in the plan’s network. You can’t visit out-of-network providers and still get coverage. These are generally the most affordable types of dental insurance.
Preferred Provider Organization (DPPO or PPO)
With a PPO, you can visit a dentist who is part of the plan’s network to save money, but if you want to visit an out-of-network provider, you can do it and still get some coverage. These cost a little more than DHMOs, but the added flexibility is appreciated by most.
Dental Indemnity Insurance Plan
A third, and not typical, option is a Dental Indemnity Insurance Plan. These aren’t as popular, because they can have higher premiums, deductibles and copays. However, if you want full flexibility, they may be the right choice for you.
Dental Insurance vs. Dental Discount Plan
A dental discount plan is different from dental insurance. As the name implies, it’s simply a discount plan, so you get discounts on dental procedures and preventative care. You can get a discount plan from your dentist, and it’ll help you save some money. These cost less and do not have waiting periods, which makes them an affordable alternative.
Dental Insurance FAQs
Can I buy individual dental insurance?
Yes. You can purchase individual dental insurance either as part of a health plan, or as a standalone plan. The brokers at McGregor Benefits can help you find affordable dental plans for your family. You can also get a quote now here.
Is there dental insurance that covers everything?
Preventive Care-cleanings, exams, x rays, can be covered in full on many plans. However, other dental procedures like fillings or crowns tend to have some cost sharing depending on the plan you choose.
Is it worth having dental insurance?
If you expect you will need extensive procedures in the near future, definitely. Get insurance sooner rather than later, so you aren’t hindered by the waiting period. Your annual checkups and cleaning will be covered in full, so you will receive preventative care while you wait.
How much is going to the dentist without insurance?
Without dental insurance, dental cleaning can cost $100-200, and a complete dental exam (including cleaning, x-rays and cancer screening) can cost as much as $350. A root canal is a lot more expensive, costing as much as $2,000 if you don’t have insurance.
Do all dental insurance plans have a waiting period?
No, but most will have a waiting period of 6-12 months. For major work, you may have to wait as long as two years. If you want individual dental insurance with no waiting period, consider a dental discount plan.
How much does good dental insurance cost?
Average costs for dental insurance are $15-50 monthly. A richer plan will be around $50 per month.
Is it cheaper to pay out of pocket for dental?
If you have good dental health and just need regular cleaning and annual checkups, paying out-of-pocket may be the cheaper option.