If you're wondering if the Affordable Care Act of 2014, also known as Obamacare, affects dental coverage – it does. You can buy health coverage through the online health insurance marketplace that includes dental coverage. You can also purchase a standalone dental insurance plan through the health insurance marketplace, but in order to do so you have to also purchase a standalone health plan through the marketplace.
They have a popular dental PPO plan called MetLife 2-9 Dental. They negotiate fees within their network of dentist which are lower than average and cover over 400 procedures. They offer 100% coverage on preventative care, 80% coverage on basic care, and 50% coverage on major care with a $50 deductible. Their annual maximum coverage amount is between $1,000 and $1,500.
Maintaining oral health can be more challenging for seniors and people with certain disabilities. This may be due to an inability to brush their teeth properly, as well as an increased use of medications. Plus, as we grow older, our teeth become less sensitive, so we may not notice a problem until it is too late. All of these factors make it even more important to protect your dental health as you age.1
There are few procedures that most insurance companies will not cover or only provide a discount for. Most individual dental insurance plans do not cover what might be considered cosmetic procedures such as tooth-colored fillings on molar or bicuspid teeth, dental implants or adult cosmetic orthodontics. The majority of dental companies will also limit how often certain appliances can be replaced and, in most cases, will not replace lost items. The limitations are published in the disclosures and contracts for the plan, many of which you can peruse online. Keep in mind that a new dental insurance plan is not going to cover an emergency you are experiencing right now; most have a waiting period of six to 12 months for major work. (However, some will waive the waiting period if you recently had dental insurance.) Dental groups that offer dental discount plans will let you use your benefits right away, but they only provide a discount and not full coverage. Full coverage plans will however cover your initial evaluation so you can start planning your dental procedures.
The final kind of dental insurance is indemnity dental coverage. These plans allow you to visit any dentist and they will pay a fee for the procedures you have done. They calculate a set amount that they’ll pay for each type of procedure and any additional amount would have to be paid by you out-of-pocket. They also have an annual maximum which can sometimes be higher than other types of plans. One of the downsides is that you have to pay for all the services upfront and submit paperwork in order to get reimbursed.
*Examples only. These are the average costs the patient will pay per procedure with an in-network provider and are based on averages across Atlanta, Cincinnati, Los Angeles, Manhattan and Saint Louis. Actual costs and savings may vary by provider, geographic area, and service received. There are limitations and exclusions to the discount available. For example, general anesthesia, implants, and/or cosmetic dentistry are not discounted services. Upon purchase, refer to your policy for more information on the limitations and exclusions that apply. Coinsurance listed is for Prime Plan C.
Dental insurance plans typically cost more than discount plans, but they make actual plan payments to dental providers. Dental insurance plans usually have an annual benefit maximum of $1000 up to $3000 per year that can be paid out depending on the plan. Though insured dental plans may cost more than discount plans they may be a better solution if you need more dental care or have been accustomed to using dental insurance plans before.
We have multiple plans with different levels of benefits to help you find the best dental insurance fit for your budget.3 So if you’ve ever bought a gym membership or a treadmill to help remind you to take care of yourself, supplemental dental insurance from UnitedHealthcare can be that reminder to take care of your teeth. Even better, it can help you plan, control and budget for the costs of your dental care.