Let's Talk Dental Insurance

By Michael E. King, DDS

Michael King DDS (Mira Dental Care)

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Let's Talk Dental Insurance

It's that time. You have not been in awhile. You go to the dental office and your dentist tells you that you have seven cavities and need three crowns and a root canal. You think to yourself, “Does my insurance cover that?” If your insurance did not cover it, would you get it? Would you try to work on a plan that would get your teeth fixed overall, or just settle for just possibly losing some teeth and waiting for your insurance to kick in? This article will help you focus on how to keep your teeth while maximizing your insurance.

Step 1 Before you get insurance, go to the dentist and get a complete exam (x-rays and everything). This is vital. What you are doing here is finding out everything you've got going on so you will know how to do step 2. Once you get a handle on everything you need, then you will know how to pick out your insurance. You are probably thinking “Why do I need to come out-of-pocket when I can get insurance?” Well, there are many different types of insurance that cost different amounts based on the type of coverage. If all you ever get is a few fillings a year and a possible crown, you can get away with less expensive insurance. For example insurance cost you $175 per month for the high-end plan. It offers you $2,000 per year. You need four fillings and a crown. Your plan covers you for fillings at 80 percent and crowns at 50 percent. Another plan covers you the same, but only gives you $1,000 dollars per year and cost $75 dollars per month. Let's do the math

Plan #1 (cost is $175 per month)

175 x 12 = 2,100 per year + 500(1/2 of crown) + 100(copay for 3 fillings) = $2,700 for the year.

Plan #2 (cost is $75 per month)

75 x 12 = 900 per year + 500(1/2 of crown) + 100(copay for 3 fillings) = $1,500 for the year.

That is a difference of $1,200 dollars per year. It's important to know what you need first. Oh, and by the way, the cost of an exam will cost you anywhere from $100 to $250 out-of-pocket add that to the $1,500 above, and you still win.

Step 2 (this one is easy) Choose your insurance. Now you can choose with confidence because you are not getting “shot gun” insurance to cover everything and wasting your money. If you need help breaking down the insurance language for coverage, go to a dental office and speak with the insurance coordinator who will most likely know all about insurance breakdowns.

There you have it. Now take that money you save and invest in an Oral B electric toothbrush, or just take a trip to Hawaii. It's up to you. Happy brushing.