DHMO's are similar to HMOs in that their plans connect you with a network of dentists who give you care for a low monthly premium. With DHMO plans, you are required to go see dentists who are in their network, but in return you have lower costs, and no claim forms to fill out. DHMOs are great for preventative care and basic procedures. Some downsides include that there can be wait times if you need major or restorative dental care and some DHMOs don’t cover this types of treatment. You also need to go see your primary care dentist and get a referral to a specialist in order to get some specialized care.
Since this is an indemnity plan, you can use other insurances or coverage. A dental discount plan can work well here. Using the above example, if the dentist routinely charges $200 for cleaning, but per the discount plan contract, charges you $100, you will have a net cost of $10. Remember, most discount dental plans charge between $8 and $15 per month depending on other features.
Our top three choices offer an excellent selection of policies and discounts that can protect your savings without requiring you to pay excessive premiums. The companies service almost all markets in the U.S. Remember that you can probably go out of network to see the dentist you prefer, but you will pay more out of pocket for doing so. If you have a favorite dentist, call their office to ask what dental insurances consider them in-network.
Our dental insurance plans offer affordable options for dental coverage. The plans have low deductibles to satisfy and multiple options for the maximum amount they pay each year. Our dental insurance plans offer lifetime deductibles (not calendar year), there are no benefit waiting periods, three cleanings are covered per year, adult dental implants are covered, and you can select from various maximum benefit amounts.
Dental insurance almost always picks up 100 percent of the bill for routine checkups and cleanings. Coverage for common procedures like root canals and fillings are typically covered at 80 percent, although policies with higher premiums cover up to 90 percent. You are then responsible for the remaining 10 to 20 percent of the cost, called coinsurance. Most plans cover higher-priced and more involved procedures at 50 percent, so you should have some savings set aside for what your insurance does not cover. Still, with relatively low premiums, having dental insurance is far less expensive on average than paying cash for all dental procedures.
Coverage begins at enrollment; there’s no waiting period. All applicants are accepted, even if you have previous dental work or ongoing issues, you’re guaranteed acceptance in the plan. You can even bundle a vision plan with it, for another $14 per month. All rates are guaranteed not to change for at least 12 months, but you can cancel any time you like.
My plan covered cavity fillings, but an additional procedure (like a crown or an extraction) would have been costly even with insurance. Multiple appointments also took up a lot of time. I could have spared myself some of those cavities, and long hours in the dentist’s chair, if I’d got regular cleanings in earlier years (and, of course, flossed more often).
The AARP Dental Insurance Plan is insured by Delta Dental Insurance Company (Contract 1230) in AK, AL, DC, DE, FL, GA, LA, MD, MS, MT, NV, NY, PA, PR, TN, TX, UT, VI and WV, insured by Dentegra Insurance Company (Contract 1230) in AR, AZ, CA, CO, CT, HI, IA, ID, IL, IN, KS, KY, ME, MI, MN, MO, NC, ND, NE, NH, NJ, NM, OH, OK, OR, RI, SC, SD, VA, VT, WA, WI and WY, and insured by Dentegra Insurance Company of New England (Contract 1230) in MA. The plan is administered by Delta Dental Insurance Company. For Texas residents your Master Policy Form number is TX-AMD-MC-DPO-D-DC(DELTAUSA1-2005). These companies are financially responsible for their own products.
The longer you stay with Spirit Dental, more each plan pays out and the higher your savings. For example, with one plan’s basic dental procedures are covered at 65 percent the first year, 80 percent the second year and 90 percent the third year. Major procedures on that plan follow the same timeline at 25 to 65 percent coverage. All plans cover preventative care at 100 percent. You can bundle EyeMed vision insurance for $7 per month with each plan.
*Out-of-network/non-contracted providers are under no obligation to treat Preferred Provider Organization (PPO) plan members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.
Another kind of dental insurance plan is a DPPO which is similar to a health insurance PPO plan. What they do is they work out lower rates with dentists that are in their network who are often referred to as their preferred providers. With this plan, you can visit a dentist outside of your network, but you will not be able to get these low rates and you will likely end up paying more. Many DPPOs provide coverage of preventative care, basic procedures, and major procedures, but they only provide a percentage of this care for each.
When you near the age of 65, you need to sign up for Medicare. However, Medicare does not cover preventative dental care or other procedures such as fillings, tooth extractions, dentures or other dental devices. If you have a complicated or emergency dental procedure that requires hospitalization, Medicare Part A will likely cover the cost, but it is obviously preferable to avoid hospitalization if you can with regularly-scheduled dental care.
DentalPlans.com isn’t an insurance company, but they work with dental service providers to reduce the cost to see an out-of-network dentists. In this way the company gives access to some of the same dental benefits offered by employers through typical group insurance, but more closely resembles a prescription discount card. For example, the estimate we received for a 6-month checkup was only $15. The annual cost for the plans range from $100 – $175 depending on the location and number of people covered.
Most people know that they need to visit a dentist regularly. Having dental coverage is strongly associated with how often dental services are used. Americans often say that the cost of dental care and the lack of dental coverage are reasons for not getting needed dental care. Having an individual dental insurance plan from Spirit Dental allows you to get the regular care you need to stay healthy.