Supplemental Dental Insurance Plans

Anyone looking to enhance their dental coverage should consider signing up for a supplemental dental insurance plan. Supplemental dental insurance aims to bridge the gap where a primary dental insurance plan fails to cover care. These plans can cover implants, dentures or orthodontics, reducing out-of-pocket expenses and helping people maintain better oral health.

When you are considering supplemental dental insurance in California, review your coverage options, premiums and potential waiting periods, as you would with full-coverage dental plans. Whatever type of coverage you have, dental insurance is one step toward keeping your smile healthy and your financial strain at a minimum.

California Dental Insurance Plans

Many dental conditions are preventable, but brushing and flossing alone are rarely enough. Ongoing dental visits support strong oral health — dental insurance will help reduce the cost of necessary services. Whether the coverage is for young children or older adults, a dental plan will minimize expenses.

Full-coverage dental plans in California cover a variety of dental services. They include some level of preventive care, such as cleanings, X-rays, checkups and extensive procedures, such as fillings or root canals. Key features of a full coverage plan include:

• Basic procedures: Most dental insurance plans will cover your basic treatments like fillings and extractions.
• Preventive care: Many plans will cover your preventive services completely to encourage early detection of issues and regular dental visits.
• Major procedures: Coverage for major procedures like root canals and bridges — which can cost between $1,000 and $5,000 per tooth — and crowns may be less than for your basic procedures. Supplemental dental insurance coverage is a good idea if you need procedures like this often or anticipate that you will.
• Specialty care and orthodontics: Top-tier plans may offer full coverage for braces and other specialized treatments, which is valuable for families with children.

It is essential to consider variables like annual maximums, monthly premiums and waiting periods when shopping for dental insurance. Whichever plan you choose, you can always add extra coverage through a supplemental dental plan to ensure you are covered for anything.

Understanding Supplemental Dental Insurance Plans

Health plans purchased through the Covered California Health Exchange automatically include pediatric dental benefits for children up to age 18. Many plans available off the Exchange also include pediatric dental insurance.

Adults can get dental coverage in California by purchasing it as a supplement to their health insurance plan or on a stand-alone basis, often offering more benefits. An exception is when dental insurance supplements a health plan purchased by an employer. Small business dental plans sometimes have more coverage, and including orthodontia coverage may be more cost-effective.

To find dental coverage, contact your health insurance agent, broker or human resources department if your employer offers group health insurance.

Must-Know Dental Insurance Terms

Here are some common terms used when discussing dental insurance. Becoming acquainted with them will help you understand California dental insurance policies and choose the right one for you.

1. Deductible

A deductible is the amount you must pay out of pocket before the dental coverage kicks in. For example, if the deductible on a dental insurance plan is $100, then you have to pay the first $100 for services out of pocket. Then, your insurance will cut down or discount any additional costs.

Traditionally, a deductible usually does not apply to preventive services like routine dental cleaning and diagnostic X-rays. Some dental insurance plans do not have any plan deductibles. When a deductible does not apply to a dental service, you, the patient, pay a copay or coinsurance immediately. Just note that plans without deductibles tend to be more expensive.

2. Copayment or Coinsurance

After you pay the deductible, the insurance company will pay a portion of the bill. Your portion of the bill is called the “copayment” when it’s a fixed dollar amount or “coinsurance” when it’s a percentage of the bill. Depending on the level of dental coverage and the exact procedures, your share of covered dental visits can range anywhere from 20% to 50% of the final bill.

3. Yearly Maximum

Generally, the “maximum” on each dental policy is the most that the insurance company will pay in a calendar year. Maximums typically range anywhere from $750 to $2,000 per year. The more expensive the policy, the higher the yearly maximum will be. Once you reach the yearly maximum, you become responsible for 100% of any remaining charges unless you have a higher coverage plan with no yearly maximum.

4. Waiting Periods

Some dental services may be subject to a waiting period. Dental coverage would not apply to selected major dental services during the waiting period. A typical waiting period can be six months for fillings or crowns or up to two years for braces or wisdom tooth removal. Once the waiting period is over, dental insurance will apply.

Basic Types of Dental Coverage Plans

There are four basic types of dental coverage plans with different provider choices, cost structures and benefits. The right option depends on your needs, the level of care you or your family needs, your preferred dentist’s flexibility and your budget. The four plans are:

• Dental Maintenance Organization (DMO): A DMO works similarly to a Health Maintenance Organization (HMO). It has lower premiums with no deductibles and coverage restricted to in-network dentists. You mainly receive services from a primary dental physician, who arranges your dental care and refers you to specialists in the network.
• Preferred Provider Organization (PPO): With PPO dental insurance in California or Participating Dental Network (PDN) plans, you choose the dentist you want, and the dental coverage follows them. In this type of plan, you may also see a network dentist and pay lower service fees.
• Dental savings plan: Dental savings or dental discount plans are not dental insurance. Rather, dentists offer enrollees discounts on basic services like teeth cleaning. You pay lower premiums and must use dentists who participate in the discount plan network.
• Dental indemnity: Dental indemnity plans cover a percentage of your dental fees with no network restrictions. They do have high premiums, coinsurance and deductibles.

Find Supplemental Dental Insurance in California

At Health for California, we can help you get the best dental insurance California offers. Enjoy the benefits of both embedded and supplemental dental insurance with free preventive and diagnostic dental care. Receive prompt treatment for many dental conditions at low rates.

Requiring dental or orthodontic work can feel like a drag when you don’t have dental coverage. Understanding the basics of dental plans will help you find the right dental health insurance policy for your family, yourself or your employees if you have a small business.

Find dental plans that can be added to your health insurance and stand-alone dental plans with Health for California. We can help you purchase a family dental plan that provides adequate coverage for you and other family members. We also offer free guidance to help you choose the most suitable California individual and family dental insurance plans.

Contact us today to request a free quote. Get peace of mind and answers to all questions about choosing and purchasing family or individual dental insurance plans in California.