Stephen H. Hook DDS

Dental Insurance PlansDental insurance – which plan should I buy?

When I am asked what appears to be a simple question – what dental insurance should I buy – I am tempted to reply with the simple answer:  “None of them!”  Of course this is not a helpful answer, but this is not really a simple question either.  Obviously there are many plans being marketed to the public and each person’s situation is unique, therefore a simple answer is not possible.  The intent of this short article is to provide you the reader with some simple principles in order to understand dental insurance plans, how they work and perhaps how best to select one for you and your family.

Understanding Dental Insurance

First off, please understand that insurance companies are in business to make a profit for their stockholders. The dental insurance contracts they offer are carefully constructed to maximize that possibility.  It is highly unlikely that any plan you purchase individually will pay back more in benefits than it collects from you in premiums—at least in the short term, perhaps twelve to eighteen months.

Also, it is my belief, one shared by the marketing departments of the insurance companies I might add, that most people who wish to buy a policy are focused on short-term economy.  These people are faced with significant dental expense and they wish to find a way to lower that risk.  The insurance companies market the features of the plans they sell so as to make it appear that you can save money and get more benefits with their plan than you could otherwise.  Without getting any more complicated, I suggest you consider the odds of picking the winning lottery ticket, the slot machine that’s about to pay off or even covering the spread on the USC-UCLA game!  The odds are in the house’s favor.

Group Insurance

If you have the opportunity to be insured by a group dental insurance plan through your employer, union or trade group, usually these type of plans have much better odds of giving you benefits equal to or possibly even exceeding the premium cost.  In cases like these, if offered a choice of plans, the dental insurance plans that allow you the maximum freedom of choice of dentists (Premium or PPO plans) are the best plans even if they are more costly.  The DMO (HMO) type plans are attractive because they are usually the least expensive. But they usually require you to utilize only one dental facility and may have limitations such as waiting periods and restricted choice of treatment—no cosmetic dentistry for example.

The most common dental insurance group plan we see is known as a PPO (Preferred Provider Organization) which allows you to seek care with virtually any dentist you wish. A PPO guarantees set benefit percentages if you select a dentist from a list of their “Preferred Providers”.  Limitations are usually less restrictive and treatment options such as implants and bleaching may be covered benefits.  Waiting periods and other hidden features under these plans vary, so it is vital that you know the features of your plan since they are unique to your contract.

Individual Dental Insurance

If you are seriously considering purchasing an individual or single family dental insurance plan such as the many that are marketed in the media these days, then be very careful.  It is wise to get a detailed cost estimate and a financial arrangement plan from the dentist of your choice before you purchase any individual dental insurance plan.  Armed with this information, then you can balance the cost of the dental insurance plan and any cost savings against the actual fees from the dentist of your choice.  If there is enough of a savings to warrant the purchase of the plan the choice will be easy.  If not, there is no reason why you can’t negotiate with your dentist’s office manager and ask for more generous terms.

When it comes to dental insurance plans, there’s a lot more than cost involved.  Consider freedom of choice, waiting periods, simplicity of the business transaction and ultimately your satisfaction and emotional well-being.  It’s much better to have dental insurance than none at all unless what you bought turns out to be a disappointment.  Better inspect the horse thoroughly including his teeth before purchasing; he may not be a Culver City thoroughbred but rather a plow horse with a large appetite! You can learn more about dental insurance plans here in my video discussion: Dental Insurance