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Understanding Individual Dental Insurance Plans What They Cover

There are many types of dental insurance plans, so you should have an understanding of dental insurance and what it covers. Unlike group dental plans (which falls into one of several different categories), individual dental insurance can come in many different forms. Some dental insurance plans prefer that you or your dentist send in a proposal to a plan administrator before you receive treatment. And once it’s reviewed, he or she will be able to determine the following:

  • Eligibility
  • Eligibility period
  • Services that will be covered
  • Required co-payment
  • Maximum limitation

Be sure to look at each plan that you’re considering so you can find a plan that will meet your needs and fit your budget.

What to Consider When Choosing Individual Dental Insurance

While you’re shopping for the best dental insurance plan for your needs, you should consider the following:

  • Ability to choose your own dentist – Can you use any dentist, or are you limited to a specific panel? If you get one of these plans, you should find out if your current dentist is listed.
  • Who has control over treatment decisions – Is treatment between you and your dentist, or is the decision made by your insurance company? Some dental insurance plans may require the treatment provider to use an alternative method that’s less expensive.
  • Coverage of diagnostic, preventative, and emergency services – You should find out if these services are covered in the plan, and you should know how much is covered.
  • Coverage of routine dental procedures – Does your dental insurance cover routine treatments (like regular cleanings), and how much of the cost will you be responsible for?
  • Coverage of major dental care – Does the plan cover major dental treatments, and how much will be paid out-of-pocket? This is an important consideration if your looking for full coverage dental insurance.
  • Limitations and exclusions on your policy – Some procedures may be limited to specific amounts, and others may not be not be covered at all. So, be sure to read the details of each plan that you’re considering.
  • Ability to choose dental specialists – Does the plan allow your dentist to refer specific dental specialists, and does it leave the decision up to you and your dentist?
  • Ability to see the dentist at your convenience – Can you see your dentist when you want to, and are you able to schedule an appointment at a convenient time?
  • Eligible people who are covered in the plan – Who can be covered in your individual dental insurance, and when does it start?

Every dental insurance plan on the market will have their differences, and they’re determined by the types of contracts that companies negotiate. Whether you have a Blue Cross dental insurance plan or dental insurance MetLife, you need to shop around for the right plan.

If your child has special needs, he or she may need to do dental work at a hospital. If that’s the case, then you may need to get a plan that covers this kind of service. Your child may be too anxious, or he or she may not be able to fully comprehend what’s going on. In these cases, your child may need to be under general anesthesia in a hospital setting.

We can do a variety of examination with this method, which include:

  • Dental exams
  • Cleanings
  • Fillings
  • Root canals
  • Tooth extractions

Be sure to speak to Bade DDS to find out if this method is right for you or your child.

Possible Limitations of Individual Dental Insurance

Many dental insurance plans will place limitations on the amount of care you can receive in a single year, and it’s done to keep costs down. Insurance companies will either limit the number of each covered treatment that you can receive each year, or they may place a “dollar cap” on each benefit. Some dental insurance plans will even exclude certain services or treatments from being covered, which is another way for insurance companies to control cost. Be sure to look at the specifics of each policy so you can know exactly what is and isn’t covered.
Every full coverage dental insurance plan will exclude experimental procedures, because the cost can be too great. And they won’t cover any procedure that isn’t being supervised by a dentist. There may also be some exclusions that aren’t so obvious. There are certain situations where your medical and dental insurance will overlap, and your policy may have certain conditions if that’s the case. Be sure to read these carefully so you can understand what those limitations are.

Dental Insurance Options for Seniors

While Medicare Parts A and B won’t cover routine dental services (like oral exams and cleanings), there are certain ways that senior citizens can lower the cost of these procedures. And there are other options that can offer dental insurance for seniors. Some Medicare Advantage plans (Part C) can cover routine dental and vision procedures as well as prescription drug costs. There are quite a few plans to choose from, and there’s a broad range of premiums and coverage options.
If you want dental insurance for seniors, you can also get a Medicare supplement, which is meant to cover certain gaps in Medicare coverage. Like any other type of insurance, you’ll have to pay a monthly premium. And once the Medicare stops, the supplemental plan will kick in.
Seniors can also get a regular dental insurance plan, but you may have to pay a higher premium. However, you will pay less out-of-pocket. Most of them will require you to see a dentist that’s inside their network, but some of them will let you use any dentist you want. However, you may have pay more if they’re out of their network.
A dental discount plan can also give you some extra savings, and it’s similar to a shopping club. You pay a fee so you can get discounted rates from certain dentists, and you can pay either monthly or annually. While it’s not an insurance policy, it can help you lower costs associated with certain dental procedures.

Quality Dental Services from Bade DDS

If you want to find a quality dentist in the Hammond area, Bade DDS has an amazing staff with years of combined experience in dental care. We accept many different dental plans, which includes Blue Cross dental insurance and dental insurance MetLife. We accept all private insurance plans, and we’re networked with the following companies:

  • Guardian
  • MetLife
  • Cigna
  • Delta Dental PPO & DPO

We’re also a participant of Indiana Medicaid, which includes the following programs:

  • HIP
  • MDWise
  • Hoosier Healthwise
  • BCBS Anthem

If you need financing, we have it available through CareCredit. So, be sure to speak with us about the options we have available with their program.

If you want to find out about the services that we offer, get in touch with us today!