Dental Insurance for Dummies: An Easy Guide to the Dental Plans

Dental Insurance for Dummies: An Easy Guide to the Dental Plans
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(Note: This content was co-created with Lineberger Dentistry and Dr. Adrian S. Lineberger, DDS. Hear more from him on Instagram.)

Brush twice a day, floss, rinse, repeat. If you’re following the dental hygiene basics, gold star for you. But visiting a dentist is important, too. Dental insurance can be confusing, and believe me, not all dental insurance companies and plans are created equal, but educating yourself about what’s out there will help you find the right fit.

The truth about dental insurance

It’s a glorified maintenance plan. Unfortunately, dental insurance hasn’t kept up with inflation. Most dental insurance reimbursements only cover up to $1,200 a year. This is fine for cleanings twice a year and small fixes, but when you start getting into more tooth work, it’s coming out of your pockets. While dental insurance doesn’t cover as much as it should, it’s still better to be prepared than not.

Your four dental insurance options:

  1. Pay cash (possibility of a cash discount)
  2. Some offices offer “in house” insurance or a “savings plan”
  3. Corporate insurance through your employer
  4. Private plan

Within corporate insurance and private plans, you can choose from two tiers of coverage (PPO or DMO) with accompanying premiums. Fret not, I’ll break down these acronyms for you.

With a PPO (preferred provider organization), you can visit any dentist you want and don’t need referrals to see a specialist. It’s the more flexible of the two options. You are still able to see “out of network” dentists and still get great coverage. PPOs are generally recognized for providing high-quality dental care as well. Boom goes the dynamite!

On the other hand, a DMO (dental maintenance organization) is cheaper. It’s a relatively low-cost dental maintenance plan, but you can only go to dentists who are contracted with the DMO. Unlike a PPO, DMO networks are usually much smaller, and in turn, can have lower-quality dental care. This limits your options.

Weigh the pros and cons for what you need out of a dental insurance plan, and choose what is best for you.

What you need before your dental appointment

If you’re a new patient or have a new insurance provider, you should get these ducks in a row before your appointment:

  • Transfer your dental records from your old dentist to your new one. This requires a quick phone call or email. Easy peasy.
  • Gather your information. This includes your new insurance card (or another form of payment) and past medical history.
  • Arrive 15 minutes early. I’m not your mom, but she’s right — better early than late. And when you need to fill out a new patient form or update your insurance, it’s best to give yourself a few extra minutes.
  • Breathe. Going to the dentist doesn’t have to be a hassle. Plus, some dentists have a slide in their office. *cough cough*

Last but not least, know this – we’ll answer any q you’ve got when it comes to your dental insurance. We know it can be confusing, and we’re here to make it a wee bit easier. We certainly don’t want any question or concern about your dental insurance to deter you from coming to the dentist. The world needs that smile now more than ever.

(Note: This content was co-created with Lineberger Dentistry

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