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Finance

Individual Dental Plans – Everything You Need to Get Started

Individual Dental Plans

Whether you’re a part-time or contract worker who doesn’t have access to an employer-sponsored dental plan or are a retiree, we offer a range of individual dental plans. Consider coverage options, deductibles, and copays when choosing an individual dental plan. Most dental insurance plans cover up to 100 percent of preventive visits and 80 percent of essential services, such as fillings. Most also have a maximum annual benefit.

Get Covered

Individual dental plans aren’t required under health care law, but many people find value in purchasing coverage separate from their medical plan. A dental insurance policy can help with preventive visits to the dentist and cover costs for more complex procedures like root canals. Many employers offer group dental insurance, a convenient option for individuals because monthly premiums are often taken from each paycheck. In addition, group plans generally have lower out-of-pocket costs and an extensive provider network, and they often feature flexible benefits for the whole family. A dental insurance policy can be purchased through a healthcare marketplace or directly from an insurance carrier. There are advantages to each option, so it’s essential to carefully consider deductibles, copays, and premiums before making a purchase. Depending on your budget, it’s also a good idea to look for a dental plan with an extensive network of providers familiar with the type of treatment you need. It’s important to know that there may come a point where your dental insurance stops paying for certain services because you have reached your annual coverage maximum. If you have a high maximum, consider a dental savings account that can provide you with money to cover your expenses. You can use this money for dental treatments your average insurer might not pay for.

Find a Dentist

Several dental plans are available, from employer group coverage to individual policies. In general, plans cover 100 percent of preventive services, like cleanings and x-rays, 80 percent of essential services, such as fillings, crowns, and extractions, and 50 percent of extensive work, such as root canals and dental implants. They also usually have a deductible, copayment, or coinsurance and exclude some procedures altogether. When selecting a dental plan, it’s essential to consider the types of dentists you want to visit and the cost you can afford. Most plans have a network of providers, where participating dentists agree to offer care at a discounted rate. If you decide to go to a dentist outside of your insurance network, they may charge you more for their services. In addition, seeing a specialist may require a referral from your primary care dentist. Alternatively, you can opt for a reimbursement plan that pays a fixed amount per procedure. Such plans include health savings accounts (HSAs) or flexible spending accounts (FSAs). You can then use your saved money to pay for dental work. Individual dental plans may be right for you if your job doesn’t offer insurance if you are self-employed or retired, or prefer to avoid the annual fees and deductibles associated with traditional dental insurance. Private insurance providers typically offer these individual and family dental plans as a supplement to a health insurance policy or as stand-alone dental coverage.

Schedule a Visit

Dental insurance helps pay for preventive and primary care procedures like routine exams, cleanings, X-rays, and sealants. It also covers primary vital services such as crowns, bridges, dentures, and root canals. Some policies cover orthodontic treatment as well, but that’s less common. Most dental insurance plans have a deductible and annual maximum. A deductible is the amount that you must pay out of pocket before the plan starts to cover costs, and it usually ranges from $50 to $150 per year. Once the deductible is met, you’ll pay a flat copayment for each visit, similar to medical health maintenance organization (DHMO) dental insurance. If you’re thinking about buying individual dental coverage, it’s essential to understand how it works and compare options. An excellent place to start is with a needs assessment at your dentist. Your dentist will take a complete set of X-rays, assess your dental history, and determine what if any, complex procedures you might need in the future.

Get a Quote

People who do not have employer-sponsored dental coverage can purchase individual dental plans directly from insurance providers. There are two main types of individual dental plans: Dental Health Maintenance Organizations (HMOs) and Dental Preferred Provider Organizations (PPOs). Each type of plan has its deductibles, payments, copayments, and services that should be considered when choosing a plan. Another consideration is the annual coverage maximum, which refers to the amount of money a dental plan will reimburse for a specific treatment or service during an insurance year. This is typically a percentage of the actual cost of the service and can range from 20% to 100%. Any additional costs will be your responsibility if the annual maximum is reached. The other main factor to consider is whether you prefer a dental HMO with restricted provider networks, which are cheaper, or a dental PPO that offers more flexibility but also has higher costs. Both types of plans can provide excellent coverage at a reasonable price, depending on your needs and budget. For many people, it makes sense to get dental insurance if they have expensive or complicated procedures in the future. However, an individual dental discount plan might make more sense for those with little need for major procedures and who can afford to pay out-of-pocket for their care.

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