Understanding Dental Insurance at Delgado Dental Group
What is dental insurance and how does it differ from your medical insurance plan?
Dental insurance is an insurance plan that you can get to help cover some of the costs of dental procedures we do here in the office. It differs from medical insurance because it only covers things that happen inside the mouth. Additionally, dental insurance only covers up to a certain portion, and then everything after that is out of pocket for the patient.
How much is dental insurance on average and what factors impact the cost?
Dental insurance can average between $50 a month to $150 a month, depending on the plan you choose, whether you have family members you're adding to it, and other factors.
What are the best dental insurance plans for major dental work or extensive procedures?
The best dental insurance plans for major dental work or extensive procedures, honestly, are none of them. They only cover up to about $1,500 worth of dental treatment a year, and most patients need way more than that.
Dental insurance plans act more like a discount plan up to a certain amount, and after that, costs fall to the patient. They don't really cover major procedures.
How does dental insurance work for specific treatments like braces, root canals, or dental?
Dental insurance can help cover a certain portion. Most will cover at 50% for orthodontics and root canals, and then the rest comes out of the patient's pocket. However, they only cover up to a certain amount of the billed fee.
Is dental insurance worth it for routine dental care?
Dental insurance can be worth it for routine dental care and cleanings. Most insurances will cover 80% to 100%, so there's usually not a significant co-pay for that part. It can be beneficial for someone who just needs regular cleanings and checkups.
What dental procedures are typically covered by medical insurance versus dental insurance?
The only dental procedures typically covered by medical insurance are those needing hospital intervention. For instance, jaw reconstruction might be covered by medical insurance. Sometimes, if you can demonstrate that wisdom teeth extraction is medically necessary, medical insurance may cover it. Other than that, medical insurance generally doesn't cover dental care.
Can you explain supplemental dental insurance and why someone might need it?
Supplemental dental insurance is a secondary insurance that someone gets in addition to their primary insurance. This often happens between spouses. If one spouse has dental insurance and adds their spouse to it, they'll get a secondary.
Secondary insurance can help cover costs that a primary insurance does not, but there are stipulations. If you plan on getting secondary insurance, be sure to ask questions. Ensure there's no non-duplication clause, meaning they will not pay anything because you have primary insurance. In such cases, they're just taking your money monthly because you can't use it. So, make sure you ask questions.
How should seniors choose the best dental insurance for their individual needs?
I would always suggest seniors get an exam done first to see what's needed before obtaining a dental insurance plan. If you're someone who needs dentures eventually, dental insurance might not be the best option because they only cover dentures once every five years. You'd be paying for five years of dental insurance before they help cover a second set of dentures. Also, be careful of the verbiage and ensure they cover what you actually need. Knowing your needs ahead of time allows you to ask pertinent questions and obtain the best insurance possible.
How can patients find affordable dental insurance that fits their needs?
Again, I recommend a full exam first. Yes, it might be an out-of-pocket expense, but if you truly want to utilize dental insurance, knowing what you need ahead of time before picking a plan will help. There's a lot of verbiage and loopholes in dental insurances that they won't tell you, but we can assist you in asking the right questions to help you pick the best plan possible.
At Delgado Dental Group, you come first. Whether you need dental care or simply have questions, call us at (209) 474-8888 or email [email protected] to schedule your visit. Our team is here to help you every step of the way.