When it comes to choosing the right dental plan, there are a number of things you want to keep in mind. Do you need benefits right away? Are you only obtaining a plan to keep up with your preventive care? Will you need orthodontics? Do you want to keep your current dentist?
Those are all good questions to be asking yourself, let me tell you why.
If you are looking to have dental benefits right away, as in right after your effective date, then you want to apply for an HMO plan. They typically have less waiting periods so you will be able to receive the major services when you need them. And they usually don’t have benefit maximums.
Let’s say, your child needs braces right away and you don’t have insurance. If you apply for an Anthem Blue Cross stand-alone “Dental Premier Select HMO” or a Delta Dental, “Delta Care USA” you’ll receive the orthodontic benefit for a lot less then if you didn’t have a plan. If you applied for a PPO plan chances are there is no orthodontic benefit and even if there is you will have to satisfy a one year waiting period. No good.
If you need root canal(s), extraction of a tooth, or a crown, then chances are you will have a three, six or even twelve month waiting period before you can receive coverage for those services. And keep in mind if you have a lot of those services the final bill could be very high. That is why you also want to be sure you have a high benefit maximum or don’t have one at all. Either way it’s safest to stick with HMO coverage if you don’t have coverage and need major benefits now. It’s also good to consider and HMO if you know that you are going to need major work done and are enrolled on a PPO plan with a benefit maximum of $1000.
When you are only looking to keep up with your preventive care then it’s safe to stay with the low benefit maximum plans. You can always switch over to an HMO in the future if you should need major work. If take very good care of your teeth you will have no need for minor (fillings) or major (root canal, crowns) services. I strictly use the preventive care. I go to my dentist every six months and he always tells me that my teeth look great. I will stick with a plan like Anthem Blue Cross’, “Dental Blue 100 Basic.” It gives me the coverage I need for a monthly premium of about $20.
The best part about the Dental Blue 100 Basic is that it provides a negotiated fee for the services that are not covered. Such as the orthodontic benefit. You can get a discount on that service just because you are a member of the Dental Blue network as long as you use an in network provider.
Keeping your current dentist
If want to keep you current dentist and are not happy with you insurance coverage, then you will want to search for a PPO plan. Chances are he/she will not be included in the HMO plan of your choice. And there’s also a chance they won’t be a contracted dentist with some of the PPO plans you like. It’s best to contact your local agent and let them seek out contracted providers in your area.
If your dentist happens isn’t a member of the networks that you are interested in then it’s time to search out a new plan. You shouldn’t have a problem finding a good dentist in your area if applying for a PPO. If you apply for an HMO you can still find a good dentist, but you will have less providers to choose from. You really don’t have a choice however if you need major coverage now and are not currently enrolled in a dental plan. HMO will save you the most money.
J.C. Lewis Insurance Services has been serving the people of California since 1979. A third generation business, J.C. Lewis helps people find affordable health/dental coverage that fits their needs and lifestyle. The ultimate goal: To find you the right coverage at the right price!