When you are choosing from dental insurance, you are likely to have several options to pick from. The following briefly describes the most common types of dental insurance and what each one has to offer:
- Dental HMO Plan: These plans require you to pick a dentist that practices within your specific network. HMO plans can work great if you have dentists nearby that can meet your needs. HMOs may not be the best plan if there are fewer dentists in your area, otherwise, if there are no in-network dentists in the area you might find yourself paying out of pocket instead.
- Dental PPO Plan: These plans require you to pick an in-network dentist for general care, but if you need services that don’t get offered in your plan then your insurance still may cover some costs for out-of-network dentists. Many people like PPO options as it doesn’t box you into seeing one dentist in order to use your coverage.
- Dental Indemnity Plan: Anyone who has a Dental Indemnity Plan can use any dentist regardless of their network. Keep in mind that while the plan does pay for a certain percentage of your costs, the general overall prices out-of-pocket are higher when you use these plans.
Now that you understand the three main types of dental plans that are available to you, you can choose the type of dental insurance that works best for your personal needs.
What’s Does Insurance Cover? What Does It Not Cover?
Dental insurance will usually cover the basics and are willing to pay anywhere from 70% to 100% of the costs, depending on the plan that you currently have. These plans cover many of the basics including:
- Regular checkups
- Teeth cleaning every six months
- Fluoride treatments for children of certain ages
- Sealants for children of certain ages
- Root Canals
Some other, more advanced therapies will require you to pay more out of pocket for these services. However, if you choose a provider that is in your network, many procedures are subject to a 10 to 35% discount on the regular prices. Some of these sorts of procedures include the following:
- Orthodontics to cover things such as braces
- Referrals to orthodontic specialists
These sorts of treatments may require additional payments, or in some cases, you may be responsible for most/all of the cost depending on what kind of insurance coverage you carry. Consider choosing a dentist in your network to receive some more advanced services at a discount rate.
How Do I Choose the Best Plan?
Everyone’s individual needs are different, and so are the perks and benefits that each different dental plan offers. When you are considering your dental insurance for the calendar year, you want to decide what kinds of dental needs you anticipate having in the upcoming year. Factors such as how many dentists you have to choose from in your area and how many are in your insurance’s network will help determine which insurance plan will work best for you.
If you plan on having children who will get braces in the next year, or plan on having extensive dental work done, you want to look for a plan that will pay a higher portion of the premiums on the services you need. If you plan to get traditional dental care, you might be able to afford to pay more of the cost than you would if you planned on having extensive work done. It is also important to note if you are need of pediatric dentistry, you should ask your healthcare provider if your children are covered under your plan.
What If I Don’t Have Dental Insurance?
For those who do not have dental insurance, Esthetix Dental SPA have a variety of different options that can help assist you in affording the dental care you need. We are happy to work with you to come up with a plan that allows you to get your dental work completed.
Our Washington Heights location offers reasonable self-pay programs and rates which make dental care accessible to those without insurance.
At Esthetix Dental Spa, We…
At Esthetix Dental Spa, we are happy to assist you with your dental needs no matter what insurance plan you have. If you need a reasonable self-pay option in order to get dental work done, please contact us here at Esthetix Dental SPA and we will be happy to help you set up a consultation appointment to help you take care of all of your dental needs!
After all, our goal is to keep you smiling through quality preventative care and any other services that you need!