Does Full Coverage Dental Insurance Exist?

By Natasha Gayle

It is no secret that the cost of healthcare is rising. While the medical coverage that many Americans either purchase for themselves or obtain through an employer often does a decent job subsidizing the cost of doctor’s visits and procedures, the same cannot be said of dental coverage, which is frequently both expensive and limited in what it will cover. That begs the question: does full coverage dental insurance even exist?

What About Indemnity Dental Insurance?

In years past, when individuals obtained dental insurance, it was invariably through what is called an indemnity plan.

Pros:

• You are not restricted in your choice of dentist; you can see anyone you like.
• Up to 100% of preventative care will be covered.
• 50-80% of the cost of procedures such as fillings, root canals, and other basic care will be subsidized.

Cons:

• After you pay a deductible, your indemnity plan will cover a part of the Usual, Customary, and Reasonable (UCR) costs of your visits and procedures, leaving you responsible for the rest.
• Most policies stipulate a maximum yearly amount they will pay, generally between $1,000 and $1,500.
• You may also be subjected to a twelve-month waiting period for more complicated procedures such as dentures and crowns.

All in all, indemnity plans furnish the advantage of choice of dentist, but can often carry high deductibles, yearly maximums, and waiting periods that make them impractical for many patients. While they may be helpful to preventative care, contrary to popular belief, indenmity plans they should not be considered to be"full coverage."

Medicaid and Medicare

What about government-sponsored insurance? Can these programs be considered as full coverage? In a word, no.

Does Medicaid Cover Dental?

This program is designed to oversee the medical needs of low income Americans and some people with disabilities and is a partnership between state and federal government.

• All Medicaid recipients under 21 must be furnished with comprehensive care, including dental coverage.
• However, each state can choose the extent of coverage it will provide. If you are over 21, the quality of your dental coverage will vary according to where you live.
• Many dentists do not accept Medicaid, making it difficult for patients to access the services they need.

Does Medicare Cover Dental?

This is a federal insurance program available to senior citizens and people with disabilities.

• By law, Medicare is prevented from helping patients pay for regular dental care. This includes routine visits and cleanings, fillings, root canals, dentures, and crowns.
• In fact, the only services Medicare will cover involve complicated situations. For instance, the program will cover the extraction of teeth, but only if that is necessary before another medical procedure such as kidney transplant can go forward.

Truly, neither Medicaid nor Medicare can be relied upon for full dental coverage.

Dental HMO’s and PPO’s

If you are employed, you may be fortunate enough to get dental benefits of some kind from where you work. In most cases, your insurance will fall into one of two categories.

It may be a Health Maintenance Organization (HMO) in which you must provide a pre-payment. In exchange, you can receive a full range of dental services within a specific network of doctors.

• Often, basic services will be covered in full, but you may be expected to pay a portion of the cost for more complicated procedures such as dentures and crowns.
• If you choose to see a dentist outside the network, you must pay the entire bill yourself.

In the Preferred Provider Organization (PPO) model, you have a lot more leeway as to what dentist you see.

• Dentists in PPO networks get paid in full for the services they provide. This means that far more oral care professionals are members of PPO networks.
• The premiums you pay for PPO’s are often higher, but you have a great deal more flexibility and choice when it comes to the dentists you can see.

Still, neither HMO’s nor PPO’s offer the Holy Grail of insurance; finding full dental insurance coverage is virtually impossible in this day and age.

Can Dental Savings Plans Fill the Gap?

If you’re looking for comprehensive dental coverage at an affordable price, you might think there are no additional options. Without a doubt, everything from traditional plans to government-sponsored ones, from HMO’s to PPO’s, have fallen far short of the mark.

Discount dental plans, however, are an alternative that may help patients most. In these models, a patient base, often millions strong, visits network dentists to obtain affordable dental services. Because discount dental plans can guarantee dentists a steady stream of patients, they are able to negotiate extremely low prices for a full range of dental services, from the most routine to the most complex.

• There are no long waits for services, nor are there yearly maximums.
• Monthly fees are extremely affordable, just $24.95 a month for an entire family.
• There is no complicated paperwork and no nasty surprises.
• Best of all, patients who join these plans can know beforehand exactly how much a procedure will cost and what they may be required to pay.

Conclusion

In the best of all possible worlds, we would be able to obtain dental coverage that paid the entire cost of any and all procedures. Paperwork would not exist, and we would be able to see any doctor. Although we are far from this reality, dental savings plans may well be the closest thing. Sign up for one of these programs, and you can immediately receive the care you need at prices you can afford.