Your dentist just told you that you need a root canal and a crown. No worries, you figure, you’ve got dental insurance. But wait … you’re not covered? Why? Because you’ve hit your annual cap.
That cap is the annual maximum coverage provided by your plan. Bizarrely, dental insurance policies generally limit coverage to $1000 -$1,500 a year – a rate that hasn’t changed for about forty years. To put that in perspective, back in 1970 $1,000.00 gave you the buying power of $6,273.87 in 2016.
The average cost for a crown these days is $750-$2000 per tooth, and the cost of a root canal is $750-$1,000+ per tooth (that price can soar if you need a complex root canal). Obviously you can exhaust your annual dental coverage of $1000-$1500 fairly quickly. And when your dental costs for most procedures go over that limit, you then have to pay for your own dental care out of pocket for the rest of the year.
Pre-planning helps you get the most from your dental coverage. Don’t hesitate to talk to your dentist about scheduling treatments that meet your insurance maximums. For example, if your plan provides a year’s coverage starting in January and you need a root canal and crown that will cost about $3,000 you might be able to get $1500 worth of care in December, and finish your treatment in January. That’s assuming, of course, that you have your full annual maximum unused by the end of the first year, and are willing to exhaust your coverage at the beginning of the next year. It’s also assuming that you’re not in pain, and/or your dental issue doesn’t require treatment ASAP.
You can also ask your dentist about a payment plan for the amount that your insurance won’t cover, or you may want to consider supplemental dental insurance coverage or a dental savings plan.
You can get a supplemental dental insurance coverage plan only for a year or two – perhaps to help pay for orthodontia (braces) or other types of expensive dental care such as dental implants or veneers. Just make sure that there’s no waiting period before coverage for the procedures you need is available.
Dental insurance typically doesn’t provide immediate coverage for pre-existing conditions. With a new-to-you plan, you’ll usually have to wait six months for basic restorative services or a year for major restorative services.
The good news is that supplemental dental insurance policies tend to have no annual spending limits and no deductibles. You can often find a plan that provides coverage for specific procedures. Supplemental plans also usually don’t have waiting periods and restrictions on preexisting conditions.
The bad news is that supplemental dental insurance policies also tend to be expensive, assume you’ll pay at least as much for your supplemental plan as you do for your primary plan. Carefully evaluate whether the savings you receive from the supplemental plan – depending on what dentist you go to you will probably pay less as an insured patient than an uninsured one - will cover the additional costs of insurance.
(Hint: it’s worth asking if your dentist offers discounts to uninsured patients. Some do since it’s easier for them to accept cash/credit than deal with insurance company red tape).
In general, the best thing to do is discuss funding options with your dentist before you purchase supplemental insurance. Your dentist may offer to discount the parts of your treatment plan that you will be paying for out of pocket. He or she may be a member of a medical insurance loan plan. Or your dentist may suggest that you consider a dental savings plan.
Dental discount plans enable you to save 10%-60% on your dental care. There are plans that cover all treatments – from braces to dentures. There are no annual spending caps, waiting periods, approval process or restrictions on pre-existing conditions.
Dental savings plans are very affordable. The plans available on dentalplans.com range from $79.95-$199.95 annually. Plus, many of DentalPlans.com dental savings plans include additional free bonus benefits too, such as savings on vision and hearing care, prescriptions, and other wellness services. Select plans even include a bundle of health and wellness services which range from telemedicine –free consultations with local doctors who can diagnose and treat common ailments (including prescribing medications), discounts on chiropractic, alternative medicine and fitness centers, and savings on labwork and medical diagnostic services.
Visit dentalplans.com to find out about how dental savings plans can help make quality dental care affordable.