Dental Insurance With Orthodontic Coverage – What Should I Look For?

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As most dental treatments are expensive and many people do need treatment to correct a variety of teeth related problems it is essential that you have dental insurance with orthodontic coverage. Most children and students need some kind of dental treatment, as they grow older. Many need braces to correct various bite problems, jaw corrections and alignment of teeth, some have overcrowding of teeth and others have large gaps which need to set right before they enter adulthood. Having dental insurance can help cover at least a part of huge dental bills. No, dental insurance will cover the entire cost of any treatment whether it is braces or root canal.

Dental insurance will usually cover routine dental cleanings, x rays, root canals, filling cavities and usually braces. How much of each treatment is covered is usually laid out in the documents of the dental plan you are opting for. Different types of dental treatment of covered differently. For example a braces treatment that is considered essential for good oral health may be covered up to 50 percent but a cosmetic braces treatment may qualify for only 10 percent of the treatment charges.

Before you opt for dental insurance with orthodontic coverage here are some vital points to consider

  • 1. Is the dental insurance open panel insurance? An open panel allows patients to choose their own dentist
  • 2. Are you and your dentist allowed to choose what treatment is best for you? Or do you have to go by LEAT – least expensive alternative treatment?
  • 3. Does your insurance cover emergencies?
  • 4. What is extent and amount to which emergencies are covered?
  • 5. Does it cover diagnostic and maintenance treatment? Like regular dentist visits, routine x-rays and dental cleanings?
  • 6. Does your insurance cover major procedures like implants, dentures and braces? If they do cover how much percentage is paid for by the insurance? (If you need higher coverage you will need to pay higher premiums)
  • 7. If you need specialist treatment for any reason will your plan cover it? Again do you have choice or pick a specialist from their list of specialists?

The above questions should help you under dental insurance a little better and you can wade through the technical jargon without getting completely confused. Companies that sell dental cover include Aetna, Humana and Delta. They offer personal, group or student PPO and HMO plans.

There are basically two types of dental insurance plans. One is the fee-for-service plan where every time you visit the dentist and seek treatment the insurance reimburses you on each service availed.

PPO and DHMO plans on the other hand are managed care plans. In the PPO plans the patients have to pick from a panel of preferred providers. If you go to a dentist out side this list then you will be penalized by having to pay extra in out of pocket charges. DHMO or HMO is the least expensive of the plans here dentists are rewarding for keeping the patients in good health without need for emergency treatment. The plan pays a fixed fee to the dentist for providing certain types of treatment to the patients.

Whatever the plan you pick check whether you are getting dental insurance with orthodontic coverage i.e dental cover that pays for braces at least partly.

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