What to look for when purchasing dental insurance

Tuesday, January 27, 2015
ABC-13 uncovered some of the cheapest options to keep your dentistry needs covered.
ABC-13 uncovered some of the cheapest options to keep your dentistry needs covered.

HOUSTON (KTRK) -- February is National Children's Dental Health month, we decided to uncover some of the cheapest options to keep your dentistry needs covered.

The average annual fee without insurance for two cleanings, two exams per year, and x-rays averages $45, so it is in your best interest to get insured.

Houston dentist Dr. Terri Alani says there are some things you need to know before buying dental insurance.

"First of all, what you want to look at what the maximum is. The maximum is what the insurance company will pay out over the course of the year, and it can vary. What you want to look for is a maximum amount of $2,500 and up," Alani said.

Once you've found a plan with a maximum of at least $2,500, next take a look at the dedutctible.

"A deductible is like car insurance, so you have to pay a deductible before they will start paying toward the cost of your care. A good deductible will be $50 to $100," Alani said.

The next thing to look at is reimbursements, but this is where many consumers get confused.

"There are three different tiers for the reimbursements. The first one is preventive," Alani said.

Preventative includes the cost of a cleaning, exam, and x-rays. It is typically covered 100 percent. But for people with employer-based dental insurance, it can be misleading.

"100 percent does not always mean 100 percent of what the dentist charges. It means 100 percent of what the insurance company has decided between the employer and the insurance company," Alani said. "For instance, a dental office can charge $100 for a cleaning, but an insurance company may say reasonable and customary is $80. That doesn't mean that the dentist has charged too much. That is just the fee that the insurance has decided to pay."

A plan with basic coverage is usually covered at 80 percent, and that involves fillings, periodontal treatment, or extractions. Be careful because some policies only cover 50 percent.

Another tier to consider is major coverage, which includes crowns and dentures.

"If you have a lot of dental work and you are going to need lots of crowns, you might want to look at a policy that allows more on major work. It's usually at 50 percent," Alani said.

With major dental coverage, make sure there is not a waiting period.

Dr. Alani's entire interview with Patricia Lopez