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Dental insurance can help you allay the costs of routine dental work, and help get you to the dentist regularly for preventive treatments. But when you enroll in dental plans, you may have questions, as plans and options can vary.

At Carolina Oaks Dental Care we hear patients’ insurance questions every day. Once you’ve enrolled in a plan, things become clearer, but if you are in the process of enrolling, you probably are wondering which plan is best for your family. The following frequently asked questions (FAQs) may help you understand your options better.

Do you have questions about your dental care or dental insurance? Contact our helpful staff at Carolina Oaks Dental Care, and we’ll help you understand your situation. Call us at 864-261-3132 to make an appointment with our Anderson, SC dentist.

Who needs dental insurance?

Pretty much anyone who has a family or has a history of needing dental restorations can benefit from dental insurance. In some cases, it may be more affordable for you to simply pay for routine visits out of pocket, but, in most cases, dental insurance will save you money.

Since most dental exams and cleanings are covered twice a year, dental insurance actually helps many people make sure they keep their appointments–which is good for your health. If you or your family have been avoiding the dentist due to the cost, enrolling in a dental plan will help you get back on track to a state of excellent oral health, which can prevent costly procedures in the future.

If you are one of the lucky 1% of people who do not get cavities, or if you’ve only had a few cavities throughout your life, you may be better off paying for routine preventive dental visits yourself. Add up the cost of two six-month visits and a dental filling or two, and compare that to your monthly insurance payment, times twelve months. It may be less. Ask your dentist if you’re not sure whether dental insurance is right for you.

What is covered by dental insurance?

The greatest benefits from dental insurance come in the form of routine preventive visits. For most plans, six-month visits for dental cleanings, exams, and fluoride treatment are fully covered. Since preventive dentistry is the best way to avoid painful and costly dental emergencies in the future, this is a great way to invest in your family’s future health.

Dental plans usually require a patient contribution for dental fillings, root canals, and periodontal treatments, but usually this is only 20-30% of the total cost. More complex dental work, such as bridges, crowns, and dental implants usually require you to contribute more, sometimes up to 60%. But, considering the infrequent nature of these types of restorations, dental insurance is still better than paying on your own.

The treatment you will have to pay the most for out of pocket is usually orthodontia. If you have children who might need braces, look closely at what is covered before you choose a plan. Like many dental conditions, misaligned teeth (malocclusion) tends to run in the family. If both you and your spouse needed braces when you were younger, there’s a good possibility your child(ren) will need braces, too.

What kind of coverage do I need?

Most dental insurance providers offer two levels of coverage, to give you either basic or extended benefits. Extended coverage usually pays for more, but if you only use your insurance for routine preventive visits and occasional dental fillings, it may not matter.

When deciding between basic and extended, you will want to consider the following factors:

  • Your Dental History: If you have a history of needing dental work on a regular basis, you may benefit from greater coverage in case you need complex restorations in the future. If you or a family member has been avoiding the dentist for a number of years, you may need a multi-step treatment plan to get you back into a state of good oral health, which could be costly on a basic plan.
  • Your Family’s Needs: If you have a large family, out-of-pocket costs can add up quickly, even with preventive treatments fully covered.
  • Your Overall Health and Health History: A number of medical conditions can contribute to oral health problems. If you suffer from acid reflux or diabetes, or any condition that requires you to take medication daily, you may be more prone to tooth and gum problems. Even pregnancy and menopause can cause you to need more frequent visits to the dentist, as gingivitis and periodontitis often develop during these times of hormonal changes.

What’s the difference between a DHMO and a PPO?

Both of these types of plan can provide great dental coverage for you and your family. However, they vary greatly in the number of providers you will have access to. PPOs are more flexible, as they give you a larger pool of dentists you can visit, and will even let you visit out-of-network providers, albeit at a different rate. DHMOs are less flexible in your provider options, but are more affordable. If you want to have the option to choose a particular dentist, a PPO is ideal. However, if you live in an isolated area where all dentists are far away, you may be able to save money by enrolling in a DHMO. Call your insurer if you have questions about specific dentists.

Do you have questions about your dental care or dental insurance? Contact our helpful staff at Carolina Oaks Dental Care, and we’ll help you understand your situation. Call us at 864-261-3132 to make an appointment at our Anderson, SC dental practice.

Dr. Layne

Author Dr. Layne

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