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 Dental insurance helps pays for routine dental care as well as injuries caused by accidents. Policies typically cover oral exams, x-rays, cleaning, fillings, extractions, bridgework, dentures, oral surgery, root canals, and related services.
Coverage is usually subject to a deductible, and the patient is required to make a co-payment of 20% to 50% of the cost. This coverage is designed to ensure that the insured receives regular examinations and care to prevent dental disease. Dental plans commonly cover the costs of regular teeth cleaning procedures and dental examinations.
There are basically two types of dental plans: 1) Preferred Provider Organization (PPO), and 2) Exclusive Provider Organization (EPO).
In general, plans that allow the patient to choose any dentist will cost more than one in which the patient must select a dentist from a group with rates set by an agreement with the insurer. Dental plans can differ on the basis of treatment, the services they provide or the payment method and manner in which they control costs.
However, most dental plans cover certain diagnostic services, preventive, and emergency treatment, and routine services are usually covered without a deductible or co-payment.
Although preventive care reduces the chance that the insured will need more extensive treatment, additional treatment may still be necessary to maintain health. Such routine care or treatment can encompass a wide variety of procedures with plans covering 70% to 80% of the treatment. The insured pays the balance of the cost.
Major care are usually covered for less than half of the cost under most dental insurance plans. Benefits can be limited to a certain number of procedures and a dollar amount per year.
Some plans may limit visits to specialists. They may require that the dentist refer the patient to a specialist before covering any treatment by a specialist.
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