Dental Insurance

The Shoppe has been receiving a lot of inquiries in the past couple of months on stand-alone dental insurance.  Stand-alone is coverage that does not need to be purchased at time of acquiring a health insurance plan.

Plan can range from $14-$38/month (for single coverage) and range from HMO to PPO plans of coverage.

What does Dental Insurance cover?
Dental insurance will cover your preventative care which is two annual cleaning and X-Rays that come with.  As long as your dentist accepts your dental insurance you would not owe anything for these services.

Preventative will be the only immediate benefit and you will be subject to a 6 month waiting period for Basic Services and a 12 month waiting period for Major Services.

After the waiting periods you would only be able to receive anywhere from $1,000 - $1,500 at the most in annual benefits, payable by the insurance carrier.

Basic Services
All Basic Services will be subject to a 6 month waiting period other than dental coverage with BCBSIL that must be acquired with a plan of health insurance and begins at $26.55/month for single coverage.  Basic Services include:

• Fillings, resin or amalagram
• simple extractions (not wisdom teeth)

After the waiting period these services are typically covered at 50% or 80% by the insurance carrier with benefits payable to the plans maximum at the negotiated rate of service if in-network or up to the maximum allowable amount if services are rendered at a non-participating dentist.

Major Services

All Major Services will be subject to a 12 month waiting period other than dental coverage with BCBSIL as mentioned prior.  Major Services include:

• Endodontics (root canal / therapy)
• Periodontics (gum surgery / oral surgery)
• Crowns
• Bridges
• Dentures

After the waiting period these services are covered at 50% by the insurance carrier with benefits payable to the plans maximum.

The thought process to getting coverage is that you are paying a premium to receive services after a 6 - 12 month waiting period, but at the same time will receive cleanings at no cost.  If your teeth are in good condition and you maintain cleanings annually or semi-annually than your cost for the cleanings will be lower than the cost of the dental insurance premium.

If you are planning on having basic or major services done in the next 6 months, than dental insurance will not be a benefit unless you acquire a health insurance plan with BCBSIL and elect their dental coverage which does not have waiting periods.

The final thing to note is whether or not your dentist, endodontist or periodontist accept dental insurance.  If they do not, than  it will not be a benefit to obtain dental insurance for the payouts will not be worth the premium paid.

For questions on stand-alone dental coverage please call The Shoppe.

Thanks,

The Shoppe