Dental Insurance can help protect against the high costs of dental care and promote improved health through proper oral hygiene. As you would expect, early detection is key to maintaining a healthy smile and the prevention of gum disease and tooth decay. Most dental plans provide full coverage (100%) for preventative maintenance, for example at least 2 annual exams, xrays, and cleanings. It also provides substantially discounted costs for basic repairs (80%) and coverage for major work if needed (50%).
Each dental plan will have an annual limit of what the dental policy will pay. Plans with a $1000/yr or $1500/yr annual limit are typical. Higher limits will naturally increase the monthly premium. Dental plans may also include coverage for Orthodontia and/or implants. Coverage for ortho or implants will usually have a separate coverage limit that is considered a “lifetime” limit and in addition to the amount allocated to preventative, basic, or major services.
The most common types of dental insurance plans are Preferred Provider Organizations (PPO) or Dental Health Maintenance Organizations (DHMO). Both types are considered managed care. A PPO offers a larger network of dentists to pick from, however, the DHMO provides the best coverage through a negotiated fee schedule for procedures.
Employees would need to follow the same guidelines in setting up a group medical plan.
My employees are complaining that their dental plan does not cover enough of their dental expenses. Why are my employees paying so much out-of-pocket for dental care?
The cost of dental care is very expensive. Dentists who are not contracted with the insurance carriers can charge retail prices, which translates to a higher out-of-pocket cost. It is critical to stay within the network to contain costs and to know the cost of the procedures before receiving treatment. Typically, an employee spends $300-$500 in annual premium and receives $1,500-$2,000 in dental benefits. By any standard, this is a very attractive proposition.
When orthodontia coverage is purchased, typically, orthodontia will only cover children under the age of 19. However, some group dental plans may cover adults and children. Both have a lifetime maximum and an annual deductible.