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When it comes to insurance, dental coverage stands out from the rest. Unlike emergency medical services or homeowner’s insurance, dental plans aren’t just for unexpected events. In fact, if you have dental insurance, it’s best to make frequent use of it rather than keeping it solely for emergencies. Opting for group dental insurance allows you to enjoy the benefits of regular dental care while lowering the cost of premiums. Let’s explore the three main types of group dental plans:
Preferred Provider (PPO)
A dental preferred provider organization (PPO) functions similarly to medical insurance. You have access to a network of participating dentists, and by choosing a dentist within the network, you can enjoy maximum benefit and coverage options. With dental PPO plans, you may also have the option to see a licensed dentist outside the network, but you will likely have to pay a higher portion of the cost out of pocket.
To learn more about dental care and how to maintain healthy teeth at any age, visit the Mouth Healthy website provided by the American Dental Association.
Similar to a PPO, a dental health maintenance organization (HMO) also operates within a network of dental providers. However, with an HMO, you generally need to see a dentist within the network to receive preventive care. HMOs can be a cost-effective way to offset the expenses of more complex procedures.
Indemnity plans, also known as fee-for-service plans, offer flexibility if you want to stay with a particular dentist who isn’t part of a network. With these plans, employees pay the full cost upfront and are later reimbursed a percentage by the group dental insurance policy. While indemnity plans may be more expensive, they provide personalized support for gum disease, quality care, and preventive measures.
Group dental insurance plans are designed to provide employees with coverage for dental treatments, including fillings, check-ups, bridges, and crowns. These benefits can be offered as fully-funded group dental plans.
Benefits of Group Dental Insurance
Every employee desires group health insurance benefits, and dental coverage is also highly sought after. Studies show that 68% of eligible employees enroll in dental benefits when offered by their employer, making it the most popular non-medical benefit. Dental plans are increasingly valued for preventive care, making them a desirable option for employees.
Good dental health is closely linked to overall well-being. For example, individuals without dental insurance may experience other serious health issues. In fact, 67% of people with gum disease have a high risk of developing heart disease. By providing dental insurance, employers contribute to their employees’ overall health, reducing absenteeism and improving productivity.
Research conducted in 2018 revealed that in the US alone, more than 300 million work hours were lost due to dental-related issues. By offering dental health plans, employers can help employees avoid missed working hours and reduce the financial burden associated with emergency surgeries, consultations, and routine care.
Job satisfaction is also improved through dental benefits. Studies show that employees who receive health benefit plans from their employers experience less stress than those without health coverage. By offering group dental insurance, employers demonstrate care for their employees, leading to greater satisfaction and reduced turnover.
Furthermore, group dental plans contribute to improved overall health. Upgrading dental and health benefits is directly linked to job satisfaction. By providing dental coverage, employers help employees prevent dental problems and reduce the need for time off work to address dental health issues.
Financial stress can have a significant impact on employees’ well-being. Willis Towers Watson survey data indicates that 49% of employees struggle with financial stress, which can lead to depression and anxiety. By providing dental insurance, employers alleviate some of this stress and promote a healthier work environment.
Drawbacks of Group Dental Insurance
While dental insurance provided by an employer is valuable while employed, coverage can end when the employment relationship concludes. However, some exceptions may apply, as some states require continuous coverage for ongoing dental procedures. Dental insurance may cover certain problems if supported by evidence from your dentist. It’s essential to review the coverage details before signing up for dental health insurance to understand all the terms and conditions.
Cost is another factor to consider. Just because your employer provides dental insurance doesn’t mean you won’t have to contribute financially. Deductibles, premiums, annual maximum limits, and other restrictions vary depending on the insurance plan. Therefore, it is crucial to carefully review the details before enrolling in dental health insurance.
Dental insurance plans make sense for those seeking coverage for minor procedures and check-ups. However, coverage for major dental issues may have waiting periods, and you may be solely responsible for the expenses for at least six months.
What is Usually Covered Under Dental Benefits Plans?
Coverage under a dental health insurance plan can vary depending on the chosen plan and insurance company. While it is important to review the plan document for specific coverage details, the following benefits are generally covered:
- Cavity fillings
- Tooth extractions
- Root canal procedures
- Regular oral check-ups
- Gum disease treatment
- Dental surgeries
- Oral infections and cysts
- Dental implants
- Follow-up care and treatment
- Dental injuries caused by accidents
What is Usually Not Covered Under Dental Health Insurance Plans?
Typically, dental health insurance plans provide coverage for basic dental work, but certain procedures may not be covered. Some exclusions from dental insurance coverage include:
- Jaw alignment
- Expenses from cosmetic treatments
- Dental implants
- Orthodontic treatments
- Dental care related to pre-existing medical conditions
To fully understand what is covered and what is not, carefully review the coverage limits of your dental insurance plan.
Choosing a Group Dental Plan: Points to Consider
When selecting a group dental plan, several factors should be taken into account:
Premium & Coverage
The cost of the premium, or group dental services, is an important consideration for most people. Premiums usually correlate with the level of care covered by the insurance plan. Like any other purchase, the quality of dental insurance corresponds to the cost. Basic treatments such as cleanings, tooth fillings, X-rays, and root canals at in-network providers should be covered in all group plans, although specific coverage limits may vary.
Most insurance carriers set annual coverage limits, usually between $1,000 and $2,000. It’s important to consider these limits, especially if you anticipate needing major oral surgery that may exceed the yearly plan limit.
Dentists in the Network
If you have a preferred dentist, it is important to check which insurance plans they accept. While indemnity plans allow you to choose your own dentist, HMO and PPO plans restrict you to in-network providers. If you are open to seeing a new provider, an HMO or PPO may be suitable for you. However, it is always wise to check the discount plans and insurances accepted by practitioners.
When selecting group dental health insurance, carefully review the entire policy document to understand the costs and coverage details.
Offering group dental insurance benefits both employers and employees. It promotes good oral health, reduces financial stress, and contributes to overall job satisfaction. By providing comprehensive coverage, employers can ensure that their employees maintain healthy smiles, leading to brighter days and healthier lives.
Get a FREE, no-obligation estimate for a quality group dental plan by contacting us today! Call us at the number at the top of the page to learn more or get started with a FREE estimate right away by using the form to the right!