The Open Enrollment Period for health insurance is here: November 1 – January 15
Enroll in a new health plan or reevaluate your current coverage to see if it’s still a good fit for you. You can make the following changes during this period:
- Enroll in a health insurance plan for the first time
- Change health insurance plans
- Change your current plan’s dependents
Still have questions? Learn more about the health insurance Open Enrollment Period.
Basic dental care includes preventive services like dental cleanings, check-ups, and X-rays. And luckily, if you have dental insurance, many of these basic dental services should be covered.
Dental plans often cover basic dental services because they can help reduce future costs. For example, many insurances cover a cleaning every six months, which might help prevent cavities that would cost the insurance company (and you) more.
This article delves into the details of basic dental care and insurance, explaining how dental coverage works, what it typically includes, and the advantages it offers to individuals and their families.
Table of Contents
What Are Considered Basic Dental Services?
Basic dental services encompass a range of essential procedures that form the cornerstone of good oral health. These services aim to maintain oral hygiene, prevent dental issues, and keep your smile healthy and bright. Basic dental services include:
- Dental cleanings: Regular cleanings remove plaque and tartar buildup, reducing the risk of gum disease and cavities.
- Dental examinations: Comprehensive dental check-ups identify potential issues early, allowing for timely treatment and preventive measures.
- X-rays: Dental X-rays help dentists detect hidden dental problems such as cavities and bone loss.
- Oral health education: Dentists and hygienists guide proper oral care techniques and diet to prevent future issues.
- Fluoride treatments: Applying fluoride helps strengthen teeth and make them more decay-resistant.
- Sealants: Dentists often apply these protective coatings to molars to prevent decay, especially in children.
- Basic restorative procedures: Filling cavities and repairing minor tooth damage prevent the spread of decay and maintain tooth integrity.
- Gum disease treatment: Early intervention can prevent gum disease from progressing and causing more severe issues.
Overall, the main goals of basic dental care are to maintain oral health and to prevent dental issues. Many of these procedures are meant to help stop cavities, gum disease, and tartar buildup before they become a problem.
How Basic Dental Care Works
Dental plans offering coverage for basic services are one of the more common types of dental insurance. They primarily cover essential preventive and routine dental services necessary for maintaining good oral health.
Even though basic dental plans cover preventive services, they usually do not cover them at 100%. For example, you may have to pay copays for each service you receive and meet a yearly deductible before coverage kicks in. You might also pay a set percentage for dental treatments like cavity fillings or root canals. Additionally, more extensive or specialized procedures, like orthodontics or major dental surgeries, may not be included in your plan.
With basic dental care, you typically need to choose a dentist within the plan’s network. Insurance companies work out deals with certain providers, so your coverage applies when you visit one of them. Visiting an out-of-network dentist may result in reduced or no dental coverage.
Costs to Consider
Here are the key costs of a dental plan and what they mean:
- Premiums: Premiums are the monthly fee you pay for your dental insurance coverage.
- Deductibles: Your deductible is the amount you pay out of pocket before your insurance starts covering dental expenses. Deductibles vary by plan.
- Copays: A copay is a fixed amount you pay for certain dental services, such as office visits or cleanings. Your insurance plan covers the rest of the service’s cost.
- Coinsurance: This is the percentage of the cost of a dental service you’re responsible for after meeting your deductible. For example, if your plan has a 20% coinsurance and a procedure costs $100, you would pay $20, and your insurance would cover the remaining $80.
- Maximum annual benefit: Many dental plans have a limit to what they pay for covered services in a year. If you reach this limit, you are responsible for costs beyond it.
Common Exclusions From Coverage
While basic dental care plans provide valuable coverage for essential oral health services, they typically have exclusions. Common exclusions include:
- Cosmetic services: Procedures primarily aimed at enhancing aesthetics, such as teeth whitening and veneers, are often excluded. Basic dental care plans focus on preventive and necessary treatments.
- Orthodontics: Comprehensive orthodontic treatments, including braces and retainers, are typically not covered. These services fall under more specialized or extended coverage plans.
- Major dental work: Extensive procedures like crowns, bridges, and dental implants may not be included in basic dental care coverage. They often require more comprehensive or higher-tier dental insurance plans.
Some plans also have limitations on when coverage for services can start. For example, they may not provide coverage for certain basic procedures until you’ve had the plan for three months. This is meant to prevent people from signing up for insurance to have a procedure covered and then immediately canceling their policy.
Basic Dental Care vs. Other Dental Plan Types
Dental insurance comes in various forms. Two common types, aside from basic dental care plans, are preventive and major dental plans.
Preventive dental plans prioritize preventive services, including routine check-ups, cleanings, X-rays, and basic treatments like fillings. Unlike basic dental care, however, that’s all they cover. They’re designed to keep oral health issues at bay and often have lower premiums, making them budget-friendly. You’d likely choose a preventive plan if you prioritize low upfront costs, as they’re usually quite affordable. That said, because they only cover preventive services, you may have to pay for services like root canals entirely on your own.
Major dental plans, on the other hand, are more comprehensive. They cover a broader range of services, including orthodontics, major restorative work, and oral surgery. These plans also offer higher coverage limits, making them suitable for individuals requiring extensive dental treatments. Because of this extensive coverage, major dental plans also tend to have higher premiums and may have deductibles.
Preventive dental care plans are a cost-effective choice if your goal is stopping problems before they start. Basic dental care plans are like a good middle ground in that you receive coverage for both preventive services and basic services. Finally, major dental plans offer broader coverage for those with more specific dental requirements.
How to Find a Basic Dental Plan For You
Finding the right basic dental plan requires you to consider several factors. Here’s what to keep in mind:
- Consider the breadth of services covered: Evaluate the services covered by the plan. Basic dental care plans typically include preventive and minor restorative services. Ensure the plan aligns with your anticipated dental needs.
- Determine overall costs: Consider the monthly premiums, deductibles, copays, and <a class="wpil_keyword_link" href="https://assurance.com/health-insurance/copays-deductibles-and-coinsurance. Make sure the plan’s overall costs fit your budget.
- Check the coverage network: Typically, you must choose a dentist within the network to receive maximum coverage. Verify if your current dentist is in-network.
- Browse your employer-sponsored plans: Many employers offer basic dental care plans as part of their employee benefits. Explore these options, as they often provide cost-effective coverage with group rates.
- Identify the maximum benefit limit: Understand the plan’s annual benefit limit. Ensure it accommodates your potential dental expenses.
- Look for coverage for dependents: If you have family members who need dental care, verify that the plan covers dependents and offers family-friendly options.
What This Means For You
Having basic dental care insurance is a good way to take care of your oral health and prevent the need for future costly procedures. Typically, you receive coverage for common dental services like cleanings, exams, X-rays, and fillings. When choosing a basic dental plan, consider your dental needs and financial situation. Evaluate costs, network dentists, and benefit limits to ensure the plan aligns with your requirements. Selecting the right basic dental care plan can help you keep your teeth healthy. If you’re interested in basic dental care, speak with a trusted insurance agent to learn what plans may be available in your area.