Jesse Smedley
Jesse Smedley is the Principal Broker for iHealthBrokers and the founder, president, and CEO of Smedley Insurance Group, Inc. and iHealthBrokers.com. Since the inception of SIG in 2007, Jesse has been dedicated to helping people save money on their health insurance by providing them with resources to educate themselves on all their health insurance options, both under age 65 and Medicare beneficiaries. He is featured in many publications as well as writes regularly for expert columns regarding health insurance and Medicare.
What’s the most expensive dental bill you’ve ever gotten? Hands up if it’s thousands…
Yes, dental insurance is important. If you pick the wrong plan and you need major work, you’re going to have major bills.
Premium & Deductible
The first cost to identify is your monthly premium. On healthcare.gov, many health plans offer dental insurance, and there are also stand-alone dental plans. These are relatively inexpensive. In fact, dental insurance in general, especially when compared to health insurance. Private dental insurance typically ranges between $35-$65/month. You need to pay this monthly to keep your insurance active. In addition, you’ll need to meet your deductible before your insurance contributes to coinsurance or copays. These are basically the upfront costs you should be aware of.
Copays and Coinsurance
The next costs you should look at are copays and coinsurance. HMOs will offer copays. Copays are set amounts for a specific service. For example, it might cost $100 for a cavity.
PPOs will have coinsurance, which is a percentage of the cost. PPOs usually operate on the 100/80/50 split. 100% of the costs of preventative services will be covered by the insurance carrier. 80% of the costs of basic services will be covered (you’ll pay 20%). And 50% of the costs of major services will be covered. Remember, dentists set their own prices, so costs may vary.
Benefits and Networks
The network and services covered by your plan aren’t actually a cost, but they will affect your bottom line.
DHMOs are typically less expensive. Premiums are lower and copays are less expensive, BUT they only offer coverage in network. So, if your dentist isn’t in network, cross this off your list!
Then there are benefits. Read carefully. For example, your plan will cover X-rays, but maybe it’s only bitewing X-rays and not panoramics. Perhaps only metal fillings are covered and not porcelain. Again, these aren’t costs to compare, but they will affect how much for spend on your dental care.
Plan Limit
The final cost to compare is your plan limit. This is basically just the opposite of health insurance. With health insurance, if you hit a certain threshold, your insurance will pay for the remainder of your medical bills. With dental insurance, once you hit a certain threshold, YOU have to pay for the rest of your dental bills.
Many plans max out somewhere around $1000. If you need more extensive work or even just a root canal, you’ll likely hit your limit pretty quickly and then be responsible for the remainder of the bills. There are plans with higher limits, for example, NCD. This is another cost to compare.
The higher limits offered by NCD, as well as its PPO coverage, make it a favorite amongst clients. They offer plans with a 5K or even a 10K limit.
