Things to consider when shopping for dental insurance

As with any insurance, there are many things to consider when looking for dental insurance. Here are some questions you may want to think about before signing up for dental insurance.

Is my dentist part of the network plan?

Most dental insurance plans will only pay for your dental service if you go to a participating "In-Network Dentist". Just like with health insurance, many dentists will be part of a network of providers that work with insurance companies. The insurance companies negotiate costs to hopefully give you a lower insurance premium while still paying for most dental services. If your dentist is a part of your insurance network, you will pay less out of pocket expense than if your dentist is consider an 'out of network' provider. If you want to pay less, you may have to switch dentists.

Also, you need to check the Usual Customary & Reasonable -- or UCR -- fee guide your insurance company has. The UCR is a fee guide set up by the insurance company which states how much they will pay for any procedure. If you have a policy which requires you to go to a participating dentist, you should not have to be charged the difference in fees. For example, if your insurance company has a UCR fee for a dental cleaning of $80 and your dentist charges $100, you should not be charged the extra $20 -- the dentist should write that off. To be sure you won't be charged that, check the insurance company's UCR fee guide against the fees your dentist charges.

Will my insurance cover all dental procedures?

Dental procedures are broken down into three categories: Preventative, Basic or Restorative, and Major. Some dental insurance companies do not cover "Major" procedures, such as crowns, bridges, root canals, dentures and partials. If you know you will need major dental work, then you need to look for a plan that will cover this.

How long is the waiting period before I can get dental work?

Some insurance companies require a waiting period before covering some procedures. While most will cover preventative services right away, some will not cover Restorative or Major procedures for a year. If you have no major work to be done on your teeth, that may not be an issue, but if you need a crown replaced right away, you may want to find out if you have a waiting period.

What is the total yearly maximum my insurance company will cover?

The yearly maximum is the most money your insurance company will pay for your dental work in a year. The amount is different from one insurance company to the next, but most pay around $1,000 to $1,500 per year for dental services. This is nearly the same as 30 years ago, and many dentists now offer financing to help you pay for services that run over that amount.

Does my insurance policy have a missing tooth/ replacement clause?

Most do. Basically, a 'missing tooth clause' means if you lose a tooth before you were covered, the insurance company does not have to replace it. A replacement clause is basically the same thing, but it applies to bridges, partials or implants until after a specified time period has passed.

As always, it is important to ask any questions of the insurance company and your dentist before you sign up for any plan. That way, you don't have surprise later on.