11 Things You Should Know About Dental Insurance

Are you considering purchasing dental insurance in Houston, Texas? It’s relatively common for people to utilize this type of coverage to help with dental expenses. However, it’s important to understand exactly how dental insurance works and what may and may not be covered with your plan. If you’re uninsured or considering switching to a new dental insurance provider, Medical Center Dental of Houston wants you to understand the ins and outs of purchasing a new policy.

1. Dental Insurance is Designed for Preventative Care

If you’re thinking that dental insurance can help you afford major dental work in Houston, you may be wrong. Most policies only cover preventative care, such as:

  • Cleanings
  • Regular Exams
  • Some X-Rays

With an average policy, the insurance company will typically cover up to 80% of the cost of fillings and up to 50% of major dental work, such as crowns, dentures, and bridges. In general, it’s designed to help people get their routine care and nothing more. However, every policy is different, so the coverage could be less or more depending on what you choose.

2. Medical Insurance and Dental Insurance are Different

Some people assume that medical insurance includes dental coverage. While employers may provide both types of coverage for their employees, dental and medical insurance are two separate things with completely different objectives. Medical insurance is designed to protect you from high medical bills that can result from unforeseen illnesses or injuries. Dental insurance is designed to encourage routine care.

3. You Should Shop Around for the Right Policy and Coverage

Most of the time, obtaining a policy through your employer is the most economical option. However, it is possible to obtain dental insurance on your own and get a better deal. Keep in mind that every company and policy for Houston members are different so you’ll want to compare several options before you make a decision. You may also want to weigh your options based on your individual oral health needs.

4. Dental Coverage Has Declined Over the Years

Fifty years ago, dental insurance companies allowed an average maximum coverage of $1500 per year. These days, that number has stayed pretty much the same, with the average policy stopping between $1500 and $2000 per year. Even though the cost of living has practically tripled since then, dental coverage remains relatively unchanged. For some people, the potential savings may not be worth it, especially if you have to start seeing a new dentist with your plan.

5. Even With Coverage, You Should Expect Out-of-Pocket Costs

It’s important to note that dental insurance does not usually mean you’ll make your monthly policy payments and nothing more. Unless you purchase a full-coverage plan, which can be very pricey, you should expect co-pays for everything from routine check-ups to all types of dental work. These amounts can also vary based on which Houston office you visit and whether or not your dentist is considered an in-network provider.

6. You Must Differentiate Between In-Network and Out-of-Network

Just because you have dental insurance doesn’t mean you can expect the same costs no matter where you seek care. Certain providers are considered “in-network” if they accept the company and policy you have, which means your costs will be lower. However, if you visit an office that’s out-of-network, you should expect to pay a bit more for service. Sometimes, these differences are minimal while other times they could be large. You’ll need to contact your dentist’s office and your insurance to determine the actual costs.

7. Dental Insurance Rarely Covers Emergency Services

If you suffer an unexpected injury or dental emergency in the Houston area that requires immediate care, your insurance provider likely will not cover it. Again, this will all depend on your policy and whether or not your emergency dentist accepts your current plan. It may also take some work on your part to convince an insurance company to pay for work unless there is proof that it was necessary. A good dentist can submit X-rays, images, notes, and other proof to help ensure you get a better payout in certain situations.

8. There May Be a Lengthy Waiting Period for New Policies

If you know you need some serious dental work in the near future, now may not be the time to apply for a new policy on your own. Many insurance companies require a waiting period of several months before they will cover non-preventative procedures at all. This is to protect the insurance company from losing money since you can usually change or cancel your policy at any time. If you are uninsured or looking to switch to a new policy, it likely won’t help you save on dental work for quite some time.

9. Cosmetic Procedures Aren’t Covered

If it’s not necessary to maintain your oral and overall health, an insurance company is not going to pay for it. Your coverage probably won’t include whitening treatments, veneers, or any other type of cosmetic procedure. Most of the time, braces or any type of tooth alignment are also considered cosmetic. In addition, it’s very likely that your insurance will only cover the least expensive option when it comes to necessary treatments, so you may be forced to settle for an option that doesn’t offer the look you’d prefer.

10. You May Have to Personally File a Claim

If you visit an out-of-network provider, there’s a good chance that the office will not submit a claim to your insurance company. This means you’ll have to personally file a claim by retrieving the necessary paperwork from your insurance company, filling it out, and submitting it in the mail, via fax, or online in order to be reimbursed. This entire process can take weeks from start to finish. We understand that this can be a hassle for many patients. Therefore, Medical Center Dental will file insurance for you as a courtesy.

11. You Don’t Need Dental Insurance to Receive Care

While having dental insurance can help with preventative care costs in Houston, TX, it is not required to receive dental care. In fact, insurance coverage or lack thereof should never prevent a patient from getting the care they need to keep their teeth and gums healthy and to prevent decay and disease. If you’re unsure about what to expect when it comes to the cost of quality dental care, contact us! We’ll be happy to answer your questions and help you feel more prepared so you’ll know exactly what to expect when you visit our office.

Visit Medical Center Dental Group in Houston, TX

For many people, dental insurance is a great option for saving on preventative care. However, you should keep in mind that even a great policy may not keep you from paying out-of-pocket for most procedures. Above all, a lack of insurance coverage should never prevent you from getting the care you need to stay healthy.

At Medical Center Dental Group, we want to help everyone in the Houston area enjoy a healthy and beautiful smile regardless of their insurance coverage. Call (713) 795-5905 today or visit our dental office in Houston, TX.







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