Before making a decision about your dental insurance policy, ask yourself the following questions to choose the one that is right for you and your family.
Am I Eligible?
Acceptance into a dental insurance plan may not be guaranteed. Be sure to carefully review the eligibility requirements for the plans you are considering to find out if you are eligible for coverage before you apply. Before making a final decision on a plan, review it with your dentist to see if your current and anticipated future dental health care needs will be covered by the policy.
If the services you may require are not covered, you will either need to choose a different dental insurance plan or pay out of pocket for treatments that are not covered. An insurance broker can work with you to maximize your plan within your budget.
What is/is not covered?
All products and services are not covered equally from plan to plan. Some dental insurance plans cover certain treatments, partially cover others, and exclude some altogether. For example, basic dental insurance plans cover routine exams and procedures, such as cleanings, X-rays and fillings, while other plans offer coverage for major services, such as root canals, crowns and dentures.
Make sure you choose a plan that will meet your dental care needs, now and in the future. Your insurance broker will be happy to work with you, on your dentist’s advice, to help you choose a plan that fits your needs and your budget.
When Can I Begin Receiving Benefits?
Some dental insurance plans require you to wait a certain period of time before you can begin receiving benefits, while others do not. Be sure to find out if there is a waiting period before you are eligible for coverage. Take note of any differences in waiting periods when evaluating plans. If you are purchasing a dental insurance plan and expect to have coverage for major services or orthodontia, know that these are generally not covered until your third year in the plan.
How Much Does it Cost?
The purpose of a Canada Dental Insurance Plan is to reduce your out-of-pocket expenses by providing coverage for the dental care you need. But there’s more to the cost of an insurance plan than just the monthly premium. Some plans also have deductibles that require you to pay the total cost of any dental care you receive until you meet the deductible.
For example, if the plan you choose has a $250 deductible, you must pay for all costs associated with your dental care up to $250 before your insurance plan will begin paying. Be sure to review your plan with your dentist and your insurance broker to determine whether a plan with a lower premium, but a higher deductible, will help to lower your overall cost of insurance, while still providing adequate coverage for your oral health care needs.
After you meet your deductible, you may be responsible for a portion of your bill in the form of a copayment or coinsurance for each treatment. For example, if you have a 20% co-pay for any dental work, you will have to pay 20% of the bill every time you have anything done by the dentist. Be sure to account for all of your out-of-pocket costs, including the premium, deductible and co-insurance/copayments.
What is the Maximum Amount the Plan Pays for Each Covered Service?
Dental insurance plans will not pay an unlimited dollar amount for treatment. Every plan has a maximum amount they will pay for each covered product or service within a certain time period. For example, Plan A may pay up to $500 for dental care each year, while Plan B pays up to $1,000 a year.
If you have been maintaining your dental health and you only expect to see the dentist for routine treatment, a plan with a lower maximum will probably meet your needs. But, if you think you may need extensive or ongoing treatment, a plan with a higher maximum might be a better choice.
Still unsure about which plan is right for you? An insurance broker can help you make sense of the available options. Contact one of our customer service agents for additional information, and to get a no-obligation dental insurance quote.
