What is a Good Dental Insurance for Winter Park Dentistry?
What is good dental insurance for Winter Park dentistry?
If you’re looking for dental insurance, whether as a first-time individual or just comparing options offered by your employer, you might be wondering what good dental insurance is for you. Our team at Ivory Dental spends a lot of time checking, processing, and chatting with your dental insurance companies. It's a service we're happy to provide, and we get plenty of questions from our Winter Park patients to help navigate the complexities of dental coverage.
Our knowledge and advice should not replace any professional advice you have from your insurance company, employer, or your own judgment. However, being located in Winter Park, we are happy to share what we see as crucial for our local patients and provide insight into some areas that have created difficult circumstances for them at local Winter Park dental offices.
What type of dental insurance should I get?
One of the most significant factors that influence the offices, specialists, and amount of dental coverage you receive is the type of plan, which is typically abbreviated as either an "HMO" (health maintenance organization) or a "PPO" (preferred provider organization).
The key differences are that while an HMO will typically cost less in monthly insurance premiums, they lack the level of choice and flexibility that a PPO offers. HMO plans usually run on a specific network of pre-established offices, requiring referrals written by your assigned office/dentist to see specialists. In contrast, a PPO plan typically has a more extensive network of offices / local dentists for you to choose from. Additionally, PPO plans usually provide coverage to both in and out-of-network dentists, which means you have the flexibility to visit any office or any specialist you prefer.
At The Ivory Dental, we can only use dental PPO plans – and cannot utilize any dental HMO plans. It is important to note that if your medical insurance is an HMO plan, your dental plan might still be a PPO. And, of course, if you prefer to not use your existing HMO plan, you can opt to be a "self-pay" patient. If you have any questions or want us to help you check your specific plan, please call us!
What makes a good dental plan? What companies are best?
In our experience, there truly is not a "good" or "better" dental insurance company. Instead, all the major dental insurance companies have plans that are a "good" fit for you and others that may not be beneficial for you. The types of plans you have available may be limited by your specific situation or employer's pre-determined set of plans.
From what we've seen for our Winter Park dental patients, these are the most important factors when looking at dental insurance:
HMO vs PPO: Can I go to the dentists/offices I want to visit?
Sufficient coverage for procedures: Will my checkups, cleanings, and x-rays be covered with no copays? What is my copay if I need a filling? This is typically presented in percentages. The main categories are Preventative (most commonly covered at 100% with 0% copay for you), Basic Restorative (typically 80% coverage), and Major Services (typically 50% coverage).
Annual maximum: How much dentistry will be covered? Do I have enough coverage in case something were to happen? Unlike medical insurance, which often has an out-of-pocket maximum where the patient will not pay more than a certain amount, dental insurance has an annual maximum where the insurance company stops providing coverage after a set limit. We typically see Winter Park dental coverage for patients between $1,000 to $2,000 a year. When planning for coverage for yourself, we typically see a $500 annual maximum being sufficient for only checkups and cleanings. A $1,000 annual maximum would cover several minor restoratives like fillings or deep cleanings (or a single major service like a root canal or crown). Patients with an annual maximum of $2,000 or more are typically well covered for one or more major services in a year.
Waiting period: Do I have to wait before I can use the insurance? Although this typically only applies to patients purchasing dental insurance policies on their own (without an employer), we have seen waiting periods across new employee policies, too. Unfortunately, finding out about a waiting period can be a bad surprise. You may need a dental procedure performed, but the insurance policy may not cover 6, 12, or even 18 months after the policy has remained active. Most insurances provide coverage for preventative care (basic cleanings and checkups) on the first day of coverage. But they might have a 6- to 12-month wait before they will help pay for basic services like fillings and even longer for major services like crowns. If you need expensive dental care and want to purchase insurance to get coverage, be sure to look for and understand any Waiting Periods that may be in effect on the policy.
Conclusion
In conclusion, if available, we typically recommend a PPO plan for all Winter Park dental patients. It provides the most flexibility for care with us and other Winter Park dental specialists like oral surgeons and endodontists. When shopping for the right amount of dental coverage, it's important to account for the amount of coverage for the types of services you want to plan for.
If you are confident that the likelihood of needing a major dental procedure is small, perhaps a preventative plan with 100% coverage on checkups and cleanings but low annual maximum and minimal coverage for other services is best for you.
However, if you know several dental procedures are upcoming for you – perhaps selecting a higher annual maximum with good coverage across all services is better. We often provide insight to patients with a specific treatment plan on whether getting new insurance benefits them or will save them money.
We're happy to use our experience in the Winter Park and the surrounding Orlando area to help you. Please get in touch with us if you have any questions!
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