Dental insurance is a type of health insurance designed to pay a portion of the costs associated with dental care. There are several different types of individual, family or group (employer-provided) dental insurance plans. No plan will pay all of your dental-care costs, but some plans will cover more than others. With any dental insurance plan, you (or your employer) will pay a basic premium to buy the dental insurance coverage. In addition, you will often have to pay deductibles, copayments or coinsurance.
Do you really need dental insurance? You’re healthy, you take care of your teeth, you brush and floss routinely and you haven’t had a cavity for as long as you can remember. The answer is a resounding, “Yes!” Your oral health has a huge impact on your overall health. But where do you begin? To make an informed decision on dental insurance, you need a basic understanding of the key terminology.
•Annual maximum: The maximum payment the insurer will make within a given time period.
•Copayment/copay: A fixed dollar amount you pay at the time services are rendered. Typical copays are for office visits.
•Coinsurance: A specified percentage of the cost of treatment you are required to pay for after the deductible has been met.
•Covered services: Services for which payment is provided under the terms of the dental benefit contract.
•Deductible: The portion of your dental care that you pay before insurance starts covering it.
•Out-of-pocket costs: The portion of dental fees that the enrollee pays. Depending on the circumstances, it may include a copayment, a deductible and any amount exceeding the plan’s maximum, as well as optional services not covered by the plan.
Want to get even more familiar with insurance terminology? Check out our common dental insurance terms and definitions.