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How dental coverage works in different countries

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leela

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Mar 24, 2009
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179
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Canada
I think this site is primarily UK, but there are people from lots of countries on here, and I'm just curious as to how dental care is covered (or not) in different parts of the world.

I'm in Canada, and here you have to pay for it - it's all private (unlike health care which is covered for everyone). But most of us who work full time have dental benefits through our employer which usually covers 80% - 100% - up to a certain amount. I find the coverage to be excellent through these plans, or at least that has been my experience. It's not just basic things that are covered either. For example - when I get my root canal done at my endodontist, that is covered 100%, plus the crown and even the $400 for the anesthesiologist is all covered.

I'm not sure how it works with kids cause I don't have any, but I think they are covered by the government up to a certain age - perhaps 12.

But for people who have no benefits through their employer it can be rough. I know someone who doesn't, and she had to pay herself for 2 root canals - over $2000.

How exactly does it work in the UK? Is NHS a public system? What exactly does NHS stand for? And you also have a private system? Does the public system cover everyone? If so, is it just basic dentistry that is covered?

Do you have insurance through an employer or whatever that will help you pay for private? And I'm getting the impression that the private system is better than the NHS system - is that correct?

What about the folks from the US? I may be wrong, but I get the feeling from watching a lot of CNN that the insurance companies would rather do anything than pay out benefits for medical and dental coverage - but maybe that's wrong? If insurance does cover your dental benefits, is it good coverage?

I hope this isn't too boring, but I find it interesting to see how different countries handle dental costs!!

Thanks to everyone who chooses to reply!
 
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brewer734

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Mar 17, 2009
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nottinghamshire england
hi leela
ok im in the uk so here we have the nhs ( national health service) and you are very very lucky if you find an nhs dentist they are in very short supply its been going on for a while theres apparently not enough funding from our government. So if you are under the nhs it works in different ways heres how i understand it if you work you will pay at the dentist but only upto a certain amount they call it capped so you pay up to a maximum amount for what you need then the nhs pays the rest so my dad had dentures they cost all together £500 but the maximum he pays on the nhs is £198 the nhs covered the rest. The other way the nhs work is if yr not working and get benefits ( not sure what you call that in america) you get all dental treatment free which is good but only if you find an nhs dentist there are absolutely none in my area whatsoever so i have had to go private my very kind parents are paying but as i said my dentist does do a partnership thing with the nhs just for people who need iv sedation and teeth out so i wont have to pay for that at all but the rest i will and it doesn't come cheap. Im always interested in how all this works too so im glad you set this off i will watch and learn !!
By the way what happens in america if yr on benefits or not working do you get help with the dentist i don't really understand the insurance thing you have we do have insurance here but not sure how it works but would be interested to know hope brits reading cause she might know !!
by the way for more info put nhs dental charges into google that will show you a bit more hope ive got most of this right !!

emma:thumbsup:
 
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brewer734

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nottinghamshire england
oh almost forgot in my opinion private is definately better than nhs when i tried the nhs i felt rushed and there was a packed waiting room the dentists are usually stressed and that doesn't help if yr phobic private is lovely very calm no rush you get exactly what yr paying for time and reassurance !! the nhs is supposed to be accessible to everyone and yes it is a public service but good luck finding one and specially one who's got the time to spend with a phobic.

emma
 
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JessicaB

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Jan 5, 2009
Messages
277
Hi Leela, that's a really great question and I too am very curious about other countries. I am in Australia and it's almost all private, apart from small progams like the school dentist, dental schools and government/dental hospital programs, however the latter is only available to very low income earners and there are extremely long waiting lists due to the services being so limited.

Many people in Australia take out private health insurance, and this can give you some good rebates on dental treatment, but they do vary depending on the company you are with, your level of coverage and the dentist you see. This insurance is quite different to the US insurance system where people get insurance as part of their employment package a lot of the time (so I understand anyway), it's something you go and seek out and pay for yourself, a lot like car or home insurance and these days you can just give them your card at the time of your visit, and the insurance company electronically transfers their contribution to the dentist, and you only pay the balance. In the past, you had to pay the whole thing up front, then seek a refund from the insurance company.

Even with insurance, dental work can get quite expensive though, and those that can't afford insurance, generally can't afford much dental work, so they have to go on the waiting list for the dental school or government clinic, or they just don't seek dental care at all. Most of my friends and family have insurance, but those that don't are definitely reluctant to seek dental treatment (even though they could actually afford to pay if they had to/wanted to) because they are scared of a very large bill. I even have one friend who tells me she has no phobia whatsoever of the dentist, and was told a few years ago during a check-up and cleaning in Thailand that she needed some fillings, and she hasn't gone and got those fillings yet after returning from her holiday to Thailand, simply because of the cost and having no insurance to help her out with that cost.
 
S

Stress Doc

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Hello Leela:

I live in the USA. This is a private pay system. Dental Insurance covers a minimal amount, about $1000 per year. The rest is out of pocket. Insurance covers about 50% for dental work, the rest is out of pocket. It does not usually cover crowns.

An inexpensive crown costs about $900 USD, root canal $1200-$1800. These are California prices. Many employers do not offer dental insurance so most people are totally private pay.

Many dentists that I know have stopped offering payment plans. The maximum length of time they will go on payments is 90 days.
 
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drummerswife

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Very interesting question! I have actually been wondering that myself as I read the posts of others here.
I live in the USA also. And Stress Doc is very much right. In my case, my husband added me to his insurance plan when we got married and we are very fortunate to have dental insurance through his employer that offers somewhat better coverage than most people get here. The down side to havng such coverage is that my husband's salary takes a hit for it in monthly preimums.
 
brit

brit

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Info on UK NHS dentistry..updated 2009. What's covered is a bit basic given recent advances in care BUT it is free at point of use/very cheap. It is available to everyone, if you choose to use it, assuming you can find an NHS dental practice in your area you are happy to go to.

It seems to me sometimes like it is a training ground for newly qualified dentists to get a few more restorative procedures under their belt.

If you can get a referral, it would allow you to have sedation/GA free or very cheaply for say wisdom teeth extraction.

In certain cases othodontic treatment is 'free at point of use' if not purely cosmetic intent.

All hospital based care from oral surgeons is free at point of use and i.m.v. generally of high quality, as is Community Dental Service care (salaried dentists) for those with special needs.

In England especially, there are many experienced dentists who choose not to sign up to the NHS contract and you pay them privately either using 'pay as you go' or by paying a monthly amount into a scheme such as Denplan which once you are dentally fit, then provides you with checks and cleans and discounts on any restorative treatment you may need.

Having the NHS system chugging alongside helps keep private fees 'reasonable' in the UK..much needed taxpayer-funded competition for the private sector. Much easier to get TLC from a dentist who can spend time in the private sector. But if you are not dentally anxious, don't mind who you see and have reasonably healthy teeth and good oral hygiene, an NHS dentist would probably be fine in most cases...although I do worry that 'cleaning' is given a very low priority in the new contract which is more of an issue as you age.

The new NHS contract also doesn't seem to serve those who have avoided care very well..if you need a lot of work immediately, you are a very unattractive prospect to an English NHS dentist
since there is a fixed ceiling on your payment level...whereas in the past they were paid a 'piece rate' which made phobics less of a disincentive...i.e. it would be worth giving someone a 'chat only' appointment as you would then do lots of NHS work for them. This seems to have driven unethical behaviour in England (not Scotland where new contract does not apply) with complex resstorative procedures being shunned in favour of quicker cheaper extractions...test cases need to be brought to put an end to this i.m.v.

Dental cover is available as an add-on to some private health schemes such as BUPA (Non profit-making) but it would never cover an unlimited amount for dental care to my knowledge.

FROM NHS WEBSITE: QUOTE
'The maximum charge for a complex course of treatment is £198*.
Most courses of treatment cost £16.50* or £45.60*.
* These charges apply from April 1 2009.
You still receive free NHS dental treatment if you meet the exemption criteria. For more information see our 'Help with health costs' section.
Your primary care trust (PCT) is now responsible for local NHS dental services. It:
  • has money that must be used for local dental services,
  • agrees contracts with NHS dentists for services that best meet local needs,
  • can influence where new practices are established, and
  • is responsible for urgent and out-of-hours care in your area.
If a dentist moves, closes a practice or reduces the amount of NHS dentistry he or she provides, the money to provide this service now remains with your PCT for reinvestment in NHS dentistry for the local community.
Over time this is helping PCTs to ensure that NHS dental services better meet the needs of people in your area.' END OF WEBSITE QUOTE
 
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brit

brit

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The down side to havng such coverage is that my husband's salary takes a hit for it in monthly preimums.
The downside of the UK NHS system (which I happily use for medicine but not dentistry) is fairly high income tax rates....we all have to pay one way or another. The UK system is more equitable i.m.v since lack of income does not exclude you from care whether you are a taxpayer or not.
 
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brewer734

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nottinghamshire england
hey even i understand it a bit better now and i live in the uk thanks brit you are as ever a fountain of knowledge!!!!!!!!!!!!!!!!

emma :thumbsup:
 
L

leela

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Mar 24, 2009
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Canada
Thanks everyone for the info, it gives me a good understanding of the differences with all the systems covered here: UK, US, Australia and Canada. It seems they all have their drawbacks. I like the fact that in the UK anyone can get dental work done though, esp. if an emergency arises. Look at my friend here who needed 2 root canals and has no coverage through her employer - she had to pay ver $2000 out of pocket, whereas it looks like she would have been taken care of in the UK - even if it isn't the most ideal way - at least she would have had coverage, and I think that is great.

I think all countries that have a government health care system should also cover dental care. It blows my mind how dental care can be considered "optional". I know here in Canada it's assumed that everyone works and has insurance via their employer, and in most cases that's true, and then the coverage is excellent. But that is not a universal truth. Especially in this economy where jobs are being cut all around, that leaves many people without dental care, and that just doesn't seem right.

So kudos to the UK for making it available for all. It may not be ideal, but if you are suffering with pain, to know that option is there for you is fantastic.

Thanks everyone!
 
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jjjjay4

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Apr 21, 2009
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Uk but now overseas
Hi all, new to this site and just read through this thread which I found very interesting. I am one of the lucky ones to still have an NHS dentist in the UK. My previous NHS dentist who I had been with for years started to use Denplan which is great if u are younger and have a good set of teeth. I just had a crown fitted on the NHS which unfortunately fell out 5 weeks later, at a time when I was overseas. I am in Asia and was lucky enough to be recommended by a friend to a local dentist. What a differance, no pain, no fuss, a unique experiance all round. Of course it was private but I thought the cost very reasonable in comparison to what I have paid for NHS treatment in the UK.
Please understand I am not knocking our wonderful NHS but it is true that you only get what you pay for. I do hope that I have not offended any one by mentioning this. :oops:
 
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Phxcrybaby

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Oct 21, 2009
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Phoenix, Arizona
I live in the US (Arizona) and dental plans are definitely NOT offered by all employers. Many plans offer both a PPO and HMO option and the benefits are usually different as well. With a PPO plan, you can have an annual deductible (set by your insurance company) which needs to be paid out of pocket before your dental plan starts paying anything and then there is usually a coinsurance attached as well to specific procedures. For example, my dental plan has a $50 deductible every year so I need to pay this and then my insurance company pays 90 percent of allowed charges...I pay 10%. This applies to fillings, endodontic work (root canals, scaling and root planing etc). Crowns are covered at 60% so that means I pay 40%. Most plans have an annual benefit of $1000-$2000 so if you need two root canals, there goes your benefit for the year and all the rest is out of pocket. I had a root canal, one extraction and scaling/root planing and my benefits are entirely used up...and then some.

I'm one of the fortunate minority that has dental benefits so I'm not complaining but there is definitely something wrong with the system when there are millions who don't.

Trish
 
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drummerswife

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omaha, nebraska
I couldnt agree more. Read my post under the off topic section on health care care reform. Since you live in the Us, you might find it interesting.
 
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Dave48

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Jun 29, 2010
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CHESTER
I want to get braces under nhs iam over 18.

Dave.
 
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sparrow13501

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Feb 19, 2011
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I am in the US. I think the situation here really stinks. I am middle income retired person. I am NOT poor. The cost of care here is all private pay unless you are very poor -- like welfare poor. If you are welfare poor they pay for everything - extractions, IV sedation, dentures. If you are in my situation you have to pay for dental insurance that covers only about half of the cost of care and covers NO sedation. I am having four teeth extracted with just novacain - - very scary -- and it is costing me 800.00 - now they want all of that up front because the insurance will reimburse me later so I had to get a care credit card to pay for this so it puts me in debt. If i were to have IV sedation for this surgery -- and it is surgery since one tooth is completely broken off -- it would cost me 1000 for just that tooth and another 600 for the rest of the three teeth.

I am going to ask how much more nitrous oxide would be before the surgery but i am guessing here it will be at least another 200.00.

The cost of all this economically is very out of reach for many people so they have to sit with rotton teeth in their mouths until the infection kills them. Unfortunately this really impacts on the elderly who have the most dental problems. It seems wrong that people who are on welfare can have all their teeth extracted in the hospital with IV sedation and then get dentures when the ordinary retired worker has no accessibility to the same services. I do have some accessibility but only if i can endure having surgery awake without anesthesia -- -

anyway -- for all of you that have better systems -- feel blessed because the system here is barbaric at best.

Darlene in the US
 
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comfortdentist

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Miami, Fl
I am in the US. I think the situation here really stinks. I am middle income retired person. I am NOT poor. The cost of care here is all private pay unless you are very poor -- like welfare poor. If you are welfare poor they pay for everything - extractions, IV sedation, dentures. If you are in my situation you have to pay for dental insurance that covers only about half of the cost of care and covers NO sedation. I am having four teeth extracted with just novacain - - very scary -- and it is costing me 800.00 - now they want all of that up front because the insurance will reimburse me later so I had to get a care credit card to pay for this so it puts me in debt. If i were to have IV sedation for this surgery -- and it is surgery since one tooth is completely broken off -- it would cost me 1000 for just that tooth and another 600 for the rest of the three teeth.

I am going to ask how much more nitrous oxide would be before the surgery but i am guessing here it will be at least another 200.00.

The cost of all this economically is very out of reach for many people so they have to sit with rotton teeth in their mouths until the infection kills them. Unfortunately this really impacts on the elderly who have the most dental problems. It seems wrong that people who are on welfare can have all their teeth extracted in the hospital with IV sedation and then get dentures when the ordinary retired worker has no accessibility to the same services. I do have some accessibility but only if i can endure having surgery awake without anesthesia -- -

anyway -- for all of you that have better systems -- feel blessed because the system here is barbaric at best.

Darlene in the US
Nitrous oxide is fairly widely available at a cost typically from 50-90 per treatment with some incorporate the cost into their fees and a few charge rather high fees for the same.
IV sedation tends to run near 500 for the session
 
R

RP

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Please check with your medical insurance coverage- if the provider(oral surgeon) is in network very often extractions with anesthesia are included under this coverage ratehr than dental.

I am in the US. I think the situation here really stinks. I am middle income retired person. I am NOT poor. The cost of care here is all private pay unless you are very poor -- like welfare poor. If you are welfare poor they pay for everything - extractions, IV sedation, dentures. If you are in my situation you have to pay for dental insurance that covers only about half of the cost of care and covers NO sedation. I am having four teeth extracted with just novacain - - very scary -- and it is costing me 800.00 - now they want all of that up front because the insurance will reimburse me later so I had to get a care credit card to pay for this so it puts me in debt. If i were to have IV sedation for this surgery -- and it is surgery since one tooth is completely broken off -- it would cost me 1000 for just that tooth and another 600 for the rest of the three teeth.

I am going to ask how much more nitrous oxide would be before the surgery but i am guessing here it will be at least another 200.00.

The cost of all this economically is very out of reach for many people so they have to sit with rotton teeth in their mouths until the infection kills them. Unfortunately this really impacts on the elderly who have the most dental problems. It seems wrong that people who are on welfare can have all their teeth extracted in the hospital with IV sedation and then get dentures when the ordinary retired worker has no accessibility to the same services. I do have some accessibility but only if i can endure having surgery awake without anesthesia -- -

anyway -- for all of you that have better systems -- feel blessed because the system here is barbaric at best.

Darlene in the US
 
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bisja

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Jul 20, 2010
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299
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Minnesota
What I have noticed in the U.S. is that each state can be different as far as medical plans. In Minnesota we have what is called Minnesota Care they go according to your wages as to what premium you will pay every month, we also have private insurance that you can pay for, or group insurance that you would receive through your job, which you still pay so much for out of what you earn, If you work a Union job then you have insurance through your Union that you pay dues to. I have insurance through my job, my job offers dental insurance of which pays 2000$ per year. Each state is different some states offer medical plans and some do not. We are in the process of our medical programs making a change "Obama Care" which is some form of Federal Medical program has been slowly being worked in to our system, some people hate this, some people don't, and some know very little about the program as it has not been fully explained to the citizens. Some dentists will not work with State programs because they have to take such a cut in their pay, some doctors will not either. So in all reality right at this moment the United States is very messed up on how our medical system is working, and many people are worried and concerned as how things will end up. I can only say that compared to Canada our medical charges for medicine dental and regular medical are very very high in comparison. I know people who order their medicine from Canada or go into Mexico to buy there medications. My Mother and this would have been 40 years ago went to Canada (we live only 100 miles from the border) and bought her dentures there as even 40 years ago they were less then half of what she would have had to pay here.
 
Sol

Sol

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Mar 26, 2010
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USA
Some perspective from an insurance agent in the USA. Just note, I will not be recommending any specific insurance companies or organizations – just trying to share this for people that want to know more detail about dental insurance in this country. One other thing to note, things can vary widely by state or insurance policy so this is general information. If you have more specific questions about your policy consult your certificate of insurance or contact your plan’s customer service.

For people looking for information about what to do if you can’t afford a dental plan there are some suggestions at the bottom.

Health Maintenance Organizations (HMOs)
Key points:
  • These plans require you to stay in a network of approved dentists/specialist for care to get services covered.
  • In most cases, you have to advise the insurance company who your primary/general dentist will be. (If you don’t have a current dentist or your dentist is not in network you may be required to pick an in-network dentist at the time of enrollment.)
  • Plans normally have low monthly premiums, low copays and co-insurance amounts, no waiting periods for most services and no annual out of pocket maximums.
  • Typically, these plans are only offered in larger suburban/urban areas. If you live in a rural area with fewer residents (and few dentists) these plans may not be available.
Pros and Cons of HMOs
If you anticipate that you will need a lot of dental work, want a low costing plan and already have a dentist in-network then this may be an option for you. In a situation like this, your in-network dentist will accept the contracted amount the insurance plan will pay for services and you will pay a fixed copay or percentage of the cost (The amount depends on the type of service, a cleaning could be a $5 copay, crowns could cost up to $300 each as an example.). Most plans have no waiting periods so if you need immediate treatment for things like crowns or prosthodontics the majority of the cost would be covered by the HMO/waived off by the dentist. (If you are looking into implants, most HMOs do not offer coverage for implants.)

However, these plans come with draw backs. The amount the insurance company pays the in-network dentists is typically lower than what other insurance policy types would pay and lower than what a dentist would charge an uninsured person. If you were wondering why you have to register your general dentist, this is where that comes into play. The in-network dentists for some HMOs have signed a contract with your insurance company in exchange for being assigned a list of patients. Each month the in-network dentist will get a check for a small amount for each patient on that list, even if they don’t see the patient that month. This is supposed to help compensate for the lower payments for services, but as you can probably guess, dentists may still just end up breaking even or losing money for services rendered. This is why many dentists do not accept HMOs or will only accept a limited number of patients at a time from these insurance plans.

(Side-note: The following could apply to dentists in HMO, PPO or other insurance networks. If you are going to attempt to find an in-network dentist please do your research on the dentist/practice before agreeing to treatment. There are good dentists that participate in networks but be wary. There are some untrustworthy dentists (especially ones that work at dental franchises/chains) that take these plans and will recommend doing unnecessary work to make up for the small payments they get from the insurance company.

Random Fact: Aspen Dental, Alpine Dental, Absolute Dental, etc. are examples of dental franchises. Ever wonder why their names start with A? When people used phone books, I know unheard of now, their goal was to be listed first in the directory for dentists.)

Preferred Provider Organizations (PPOs)
Key Points:
  • PPOs allow you to see dentists that are in the network or out of network. However, you may be balance billed if you dentist out of network. (more on that below)
  • PPOs have moderate/high monthly premiums, annual out of pocket maximums and may have waiting periods for some services.
  • Most PPO plans follow the 100/80/50 rule.
Pros and Cons of PPOs
PPOs typically have a moderate to high monthly premium. If your plan is provided by your employer, the employer usually pays for a portion of your premium on your behalf. If you are trying to buy a PPO dental insurance policy on an individual basis you may find in some cases the premiums are 30% or more higher than the employer plan premium for the same coverage for this reason.

What do PPOs cover? Each plan may cover services at different percentages but they normally follow a similar structure. The 100/80/50 rule breaks down like this:
The plan covers 100% of the charges for preventative services (cleanings, xrays, exams, some plans may cover this at less than 100%)
80% coverage for routine work, you pay the remaining 20% (fillings for example but the services in this area can vary by policy)
50% coverage for major services, you pay the remaining 50% (oral surgery, root canals, for example but the services in this area can vary by policy)

On top of this, PPO plans usually have waiting periods. Again, this is not standard so it can vary but some policies may have waiting periods of six months, a year or longer for some services. This usually applies to things that fall in the “major services” area but some plans have a waiting period of 6 months for a filling. During the waiting period you are still paying the plan monthly premium and can have preventive services covered but any services that are part of the waiting period will not be covered until you have been in the plan long enough to satisfy the waiting period. (If you are wondering why waiting periods exist in these plans its so that someone can’t sign up for a month, get a new pair of dentures for example, and then drop out of plan only having paid the insurance company a fraction of the cost of the services.)

Another factor to take into consideration is the fact that these PPO plans have annual out of pocket maximums. Depending on the plan this can range from $1000-$2000. Unfortunately, this is the same annual out of pocket maximum that dental plans used to pay in the 1980s-1990s and has not kept up at all with inflation/rising costs. This means that you can max out your benefits fairly quickly if you need more than routine care in a given year. This is why some people see most PPOs as more like a dental discount plan. If your provider is in network the payment amount they are agreeing to is normally about 30% less than their usual going rate. With these types of plans it can be helpful to split up treatments if they are not critically needed. For example: if the PPO plan renews annually in January you could get treatment for preventive care and a crown in September (and probably max out your benefits for the year) and then have other services like fillings treated in the following February since your plan’s maximum will have reset for the new year in January.

One big difference between HMOs and PPOs is provider (aka dentist) options. With a PPO you can go to an in-network dentist or see a dentist that does not participate in the plans network. When your dentist is in network the dentist will accept the contracted amount as payment for their services and you pay a percentage for most services. (Since nothing is standardized with the plans, the cost of services can vary by provider and by state.)

Example: Charges are $100 for a filling, the PPO insurance has a contract to cover $80 for fillings. The PPO covers 80% of the $80 which is $63. This leaves $16 for you the patient to pay to cover the remaining 20%. Since in this example the dentist is in-network they will not charge for the $20 difference (the difference between what the dentist charged and what the plan was contracted to pay) and will accept $80 ($63 from insurance, $16 from you) as payment in full for the filling.

(Side note: When you see a new dentist with a PPO plan be sure to ask the office if they are part of your plan’s network if you are trying to cut down on costs. Many dental practice websites will say something to the effect of “we accept most insurance plans” but this does not necessarily mean they participate in your plan’s network. What this statement actually means is that the office will file the claim with your insurance on your behalf. Make sure you are clear on this before agreeing to treatment. Many dental practices will review this with you when going over the treatment plan. Some insurance companies will also let your dental office send their treatment plan to the insurance company before you start treatment so they can get an estimate of what they will be paid and what your out of pocket will be.)

If the dentist does not participate in your insurance policy network, they will take the payment from the insurance and bill you for the difference on top of any co-insurance left by the plan (this is called balance billing).

Example: Charges are $100 for a filling, the PPO insurance has a contract to cover $80 for fillings. The PPO covers 80% of the $80 which is $63. This leaves $16 for you the patient to pay to cover the remaining 20%. However, this dentist is not in-network so they will charge you an additional $20 to make up for the difference in what the insurance paid. In this case, the filling costs $20 + $16 = $36, compared to the same service costing $16 with the in-network dentist.

Affordable Care Act (ACA or Obamacare)
Key Points
  • You cannot purchase a dental plan by itself from the ACA, you must also purchase your medical coverage through this program to get dental coverage.
  • The ACA dental programs work like PPOs.
  • Enrollment time periods are limited during the year unless you have some special qualifying event (marriage for example) or other situation that lets you enroll outside the annual enrollment period.
  • It is possible to qualify for tax credits to help pay for the premiums for the insurance but this is based on your income and whether or not your current employer offers medical coverage to employees. (The tax credits could change or be removed at some point depending on the political climate)
  • See the website for details based on your state at healthcare.gov.
(Side note about insuring kids: The ACA laws changed medical insurance polices so that if you have an employer sponsored plan, ACA or individual plan you can continue to claim your children as dependents until they age of 26, this used to stop at age 21. It may be good to keep your kids under your insurance policy while your kids are in college or finding their footing with a job that offers benefits.

Medicare
Key Points
  • Provided by the federal government to seniors over the age of 65 and those with a legally recognized disability that prevents them from working.
  • Original Medicare (Parts A and B) does not offer coverage for dental services. (Medicare was established before the need for preventative care was understood so dental, vision and hearing care were left out in the cold.)
  • Some Part C Medicare advantage plans offer dental riders that can be added on to plans for an extra fee. Pay attention to the rider benefits, some of these riders only help cover preventative services.
  • To get dental coverage, seniors or people with a disability, can buy a dental only insurance policy directly from an insurance company (the plans will work like HMOs or PPOs).
  • More information is available at medicare.gov
Medicaid
  • Program provided on a state by state basis for people with low-income, children, pregnant women, the elderly, and people with disabilities.
  • In most cases, Medicaid only offers dental coverage for people under the age of 21 through their CHIP program.
  • Medicaid requires the use of in-network dentists.
  • In general, Medicaid pays dentists less for services (like the HMO plans) so it can be difficult to find dentist that participate in this program.
  • Coverage and guidelines can vary a lot for each state so look up your individual state at hhs.gov

Health Savings Account, Flexible Saving Account (HSAs/FSAs)
  • An HSA is part of a high deductible medical insurance plan that some employers offer or that can be purchased through the ACA.
  • Money can be set aside in an HSA to help pay for medical expenses (including dental services). If the funds are used to pay for medical/dental expenses you pay no tax on those funds. The HSA itself will work like a standard savings account at a bank and the money rolls over every year. The funds in the account can also be invested in the stock market.
  • FSAs are provided by employers and allow you to defer part of your pay check into the FSA tax free.
  • FSAs have more restrictions than HSAs but allow you to use the funds for dental expenses.
  • See the links below for more information:
    FSA: https://www.healthcare.gov/have-job-based-coverage/flexible-spending-accounts/
    HSA: https://www.healthcare.gov/glossary/health-savings-account-hsa/

I have no dental insurance…
Check out the links below first for some good suggestions about where to start with finding low or no cost dental care.

Where can I find low cost dental care?
https://www.hhs.gov/answers/health-care/where-can-i-find-low-cost-dental-care/index.html

Free Dental Clinics in the US
https://www.dentalfearcentral.org/forum/threads/free-dental-events-and-help-in-the-us.26591/

Another option would be to make an emergency fund if you don’t already have one and aren’t in need of immediate care. This can be as simple as setting up a savings account (preferably a high yield or high APY account) where you can store some funds over time for a rainy day. The amount you set aside is up to you but I would suggest an amount that would be equal or greater to what you would be paying for a PPO dental insurance plan.

Finally, some dentist work on a sliding scale (charging based on your income), offer payment plans or use services like CareCredit. Some dentist will openly advertise these services but other times you may have to ask.
 
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