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How does dental insurance work?  
Dental insurance typically works by paying a portion of the cost of dental services. The policyholder pays a premium, and when they receive dental care, they may have to pay a deductible and a percentage of the total cost of the service. If you’ve had health insurance, you’re going to be familiar with how a dental plan works. If you are still confused, I’ll explain how it works.
 

• You pay a premium, a certain amount      monthly, to buy the dental insurance plan. 

Your insurance wont’ pay for everything, so there are a few things you may want to know like deductibles, coinsurance and copays.  
 

• Your deductible is what you have to pay      out-of-pocket for services covered by your plan before the      insurance company pays.
• Your plan may include copays, a fixed      cost you pay for a certain service, like an X-ray.
• Coinsurance refers      to the percentage you pay of covered expenses after you meet your      deductible. So if your coinsurance for a filling is 20%, and the cost for      that service in-network in $100, you would pay $20 of that. The insurance      company would pay for the rest of your covered expenses up to your annual      maximum.

How much does dental insurance Cost?  
 The answer is – it depends.  
 The HMO plans tend to be less expensive and PPO plans a bit more pricey. Before buying dental insurance, first ask yourself what are your needs? Do the math. Often your annual premium is less than the cost of two visits to your dentist per year for regular check-ups. You can call your dentist and ask for the price of a visit if you pay yourself, without insurance. It’s likely that dental insurance is cheaper than paying for two visits out of your pocket. Plus, you get the added benefits of having dental coverage that will save you money in case unexpected dental issues come up. See above, the sample comparison of various dental plans available in California. By the way, comparing the dental benefits side by side is a great way of determining what type of plan would benefit you the most! There are some discount plans for as low as $9/month. PPO plans range from $35 to $80/month. The comparison is for information only and is based on California zip code.  Teeth whitening is included in most plans. Select from various Delta Dental PPO and HMO plans, Anthem, Cigna, Metlife etc. 

Q: What is dental insurance? 

A: Dental insurance is a type of health insurance that covers the costs of dental care, including routine cleanings, fillings, and other procedures.

Q: What does dental insurance typically cover? 

A: The coverage of dental insurance varies depending on the policy. However, most dental insurance plans cover preventive care, such as routine cleanings and checkups, as well as basic and major procedures, such as fillings, extractions, and root canals.

Q: What is a deductible? 

A: A deductible is the amount of money a policyholder must pay out of pocket before the dental insurance plan begins to cover the cost of dental services.

Q: What is the difference between in-network and out-of-network providers? 

A: In-network providers are dental providers who have a contract with the insurance company to provide services at a discounted rate. Out-of-network providers are dental providers who do not have a contract with the insurance company, and policyholders may have to pay a higher out-of-pocket cost to see them.

Q: What is a maximum benefit? 

A: A maximum benefit is the maximum amount of money that an insurance company will pay for dental services in a given year (typically $1000- $3,000). Once the policyholder reaches the maximum benefit, they will have to pay for any additional services out of pocket.

Q: Can I choose my own dentist with dental insurance? 

A: It depends on the type of plan. With a dental PPO plan, policyholders can usually choose any dentist within the network or opt to pay extra to see a dentist outside of the network. With a dental HMO plan, policyholders are usually required to choose a primary care dentist within the network.

Q: Do all dental procedures require pre-authorization from the insurance company? 

A: It depends on the plan. Some dental insurance plans require pre-authorization for certain procedures, such as orthodontics or oral surgery, while others do not.

Q: Can I still get dental insurance if I have pre-existing dental conditions? 

A: Yes, most dental insurance plans will cover pre-existing conditions, but there may be a waiting period before the coverage kicks in.

Q: What is covered by dental insurance?

HERE IS THE TYPICAL BREAKDOWN OF DENTAL BENEFIT CATEGORIES.

· Major– is Usually covered at 50%- Which means the insured (patient) pays the other 50%- Most of the time crowns, bridges, dentures, partials, inlays, onlays, etc are considered major.

· Basic– Usually covered at 80%- Which means the insured (patient) pays the other 20%- Most of the time fillings, extractions, periodontal services, root canals, core build up, quadrant scaling, scaling and root planing, etc are considered basic.

· Preventative– Usually covered at 100%- Which means the insured (patient) pays nothing additional- Most of the time routine cleanings, x-rays, exams, dental sealants etc are considered preventative. There are usually timing limitations to the cleanings and sealants, these are different on almost every policy.

Does dental insurance cover implants?

Dental insurance may cover some or all of the cost of dental implants, depending on the specific plan and the reason for the implant placement.

Some dental insurance plans may cover a portion of the cost of dental implants if they are deemed medically necessary, such as in cases where teeth are missing due to injury, trauma or illness. Other plans may cover implants as part of their coverage for major restorative services.

It's important to note that dental insurance plans may have limitations or exclusions on coverage for dental implants. Some plans may have waiting periods before implant coverage kicks in, or may only cover a certain percentage of the total cost.

If you're considering dental implants, it's important to review your insurance policy carefully and speak with your dental provider to determine what services are covered and what costs you can expect to pay out of pocket.

Delta Dental PPO and Blue Shield Dental PPO are both good options of dental insurance on the individual market that cover dental implants with up to $2,000 annual maximums!