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Key Features to Consider When Selecting a Dental Insurance Plan

Key Features to Consider When Selecting a Dental Insurance Plan

In reviewing and comparing dental insurance plans, consider the following when determining whether the coverage will satisfy your dental needs:

  • Does the plan give you the freedom to choose your own dentist or are you restricted to a panel of dentists selected by the insurancecompany? If restricted to a panel, is your dentist on this panel?
  • Who controls treatment decisions — you and your dentist or the dental plan? Some plans may require dentists to follow the “least expensive alternative treatment approach.”
  • Does the plan cover diagnostic, preventive, and emergency services? If so, to what extent?
  • What routine treatment is covered by the plan? What share of the cost will be yours?
  • What major dental care is covered by the plan? What percentage of these costs will you have to pay?
  • What are the plan’s limitations (a limit to the benefits for a procedure or the number of times a procedure will be covered) and exclusions (denied coverage for certain procedures)?
  • Will the plan allow referrals to dental specialists? Will my dentist and I be able to choose the specialist?
  • Can you see the dentist when you need to and schedule appointment times convenient for you?
  • Who is eligible for coverage under the plan and when does coverage go into effect?

Your dentist cannot answer specific questions about your dental insurance plan or predict what level of coverage for a particular procedure will be. Each plan and its coverage varies according to the contracts negotiated. If you have questions about coverage, contact your employer’s benefits department, your dental insurance plan, or the third-party payer of your health plan.

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