With the fairly substantial amount that a dentist charges for a crown or other restorative work these days, many of us have considered buying dental insurance privately or through your employer as a way to smooth out the cost of dental care over the year rather than having to come up with the full amount when all of a sudden an expensive crown or other dental work is needed. A dentist’s charge for a crown can easily cost between $800 and $1,000 or more depending on the dentist and the type of crown used.
While the ability to pay a more manageable fixed monthly premium is for many preferable to having to pay a large dentist’s bill all at once, there are a few key questions we should ask when evaluation dental insurance coverages. Questions such as: What is the premium cost? What is covered? And which Dentists and Dental Labs will you have access to when using the insurance coverage? Below we will address the main considerations involved in each of these questions.
Premium Cost – most dental insurance plans are based on a monthly premium. For example, one dental insurance plan that I reviewed recently had a monthly premium of roughly $50 a month for an individual coverage or $140 a month for whole family coverage. While it varies based on the company and the type of coverage, this is a reasonable ballpark of what to expect.
What is Covered – typically insurance plans group dental services into three general categories of service along the lines of Preventative (cleanings and exams), Basic Restorative (fillings and extractions), and Major Restorative (crowns, bridges, dentures and implants) with each category having a different applicable, copay or waiting period. For example, a policy may entirely cover the cost of preventative services such as cleanings and exams every 6 months, but a deductible of $50 or so may apply to restorative services and dental insurance will usually only cover between 50% and 80% of the cost of a restoration depending on what category it falls in. There may also be a six-month to a year waiting period for restorative services. Insurance companies do this so that people who already know they need a crown or other restoration won’t buy a policy right before going to the dentist and submitting a claim.
Dental insurance policies will also typically include an annual limit on the maximum amount the policy will pay out in any one plan year. The annual limits usually range from $1,000 to $5,000 depending on the carrier and whether it is a group or an individual policy. Comparing premium cost and the dental insurance policy coverages will help you to do the math on which policy may be best for you.
Participating Dentists & Dental Labs – As important as the numbers, determining whether your dentist or a dentist that you feel comfortable seeing, accepts the particular coverage or is part of the dental insurance carrier’s network is an important consideration. Your out-of-pocket costs will generally be higher if your dental work is done by a dentist that is not part of the carrier’s provider network. Most carrier’s websites allow you to search for dentists in your area that accept their coverage.
Then you can contact the dentist’s office directly to ask them, with the dental insurance you are considering, what dental laboratory would they use to make any needed restorations, where the lab is located and whether the lab employs certified dental technicians. If a dentist is reluctant or unwilling to answer these questions, that should be a warning sign. Dentists that use quality dental labs are proud of their dental lab and will be happy to share this information. Knowing this will help assure that when you need them, you will receive high quality dental restorations.
For more information about dental laboratories how to make sure you receive high quality dental restorations please visit: www.whatsinyourmouth.us
About the Author:
Eric Thorn, Esq.
Chief Staff Executive
National Association of Dental Laboratories
Eric Thorn is In-house Counsel for the National Association of Dental Laboratories and works and presents on governmental relations, regulatory and business development matters nationwide.
Eric formerly served as the General Counsel of the Florida House of Representatives and later spent over a decade in private practice representing numerous associations, private corporations and local governments.