Dental insurance keeps you healthy and protects your wallet.
Dental insurance typically covers preventive cleanings and exams 100%. This gets you into the dentist to maintain complete oral health while helping prevent costly issues to your gums and teeth. And if you’re in need of a pricey procedure or service, dental insurance lowers your out-of-pocket cost.
Some services may be found in either basic or major. It’s important to check for the specific service you’re looking for in the insurance plan you choose.
Coinsurance Coinsurance is the split cost of what the plan pays and what you pay.
From the main categories listed above (preventive, basic & major), we can look at an example for how coinsurance works.
Example: 100/50/25 (Preventive/Basic/Major)
From this, you would see that your preventive cleanings would be covered 100%, a filling would get 50% coverage and a root canal would get 25% coverage. For the root canal, the carrier pays 25% of the cost, and you pay 75%.
Some plans have graduating coinsurance that increase from year 1 to year 2 and so on up to a certain point.
Also, it’s important to note, insurance will only cover costs up to the annual max limit (see below).
Annual maximum The annual maximum is the amount of money the insurance carrier will pay out in claims each year. This money does not roll over.
In-Network Provider An in-network provider is a dentist that has accepted a contractual agreement to lower costs per procedure. This is great for the consumer, because visiting an in-network provider brings savings on procedures which can average 20-50%.
Dentists can opt in or out each year, so it’s important you know if your dentist stays or leaves your network to continue receiving these additional savings.
There is no one-size-fits-all dental insurance plan. The “best” dental insurance plan depends on your needs and your situation.
When you think “best” dental insurance plan, you may think:
• Best for families
• Best for seniors
• Best for no waiting periods
• Best for orthodontics
• Best for annual maximum
With the Direct Benefits Marketplace, we offer a variety of plans to meet these needs.
We have plans with no waiting periods to get you into the dentist ASAP. We have plans specific to families looking for child orthodontia. For seniors, we have plans with high annual maximums for dentures or implant coverage. With dental insurance, purchase what you need and keep that smile protected!
Individual dental plans cover only one person and offer a variety of plans to choose from. A family dental plan covers multiple members of the same family and can focus on child orthodontia and fillings for the kids. And senior dental plans (although not called “senior” plans) offer coverage for services when teeth begin to fade, and the need for major coverage for implants or dentures becomes apparent.
The most frequent situation that arises with dental care and pre-existing conditions is the missing tooth clause.
The missing tooth clause is very common in the dental insurance industry. If a tooth is already missing, there is nothing to insure. Therefore, insurance will not cover the prosthetic (implant) if there is no tooth existing. If your tooth is still intact, then you may be eligible for coverage.
Still, there are some plans available in certain states with limitations around coverage. For more information to see what options may exist, we have a team of experts ready to answer your questions: (888) 890-1944.
Vision insurance helps keep your eyes healthy and cuts down on costs. You’ll save on regular maintenance (eye exams, glasses and contacts), as well as costs covering the diagnosis of eye disease.
Visiting an optometrist will keep your vision on track and will also help prevent compounding issues by catching them early. Vision insurance also provides an allowance and a discount for glasses or contacts each year. Some plans also include prescription sunglasses!
Yes, some of our dental plans offered also have a vision rider add-on for as low as $7 a month. You can also purchase separate dental and vision plans using the Marketplace to ensure coverage that best suits your unique needs.
Medicare plans offer limited coverage for vision insurance. There are restrictions put in place for certain vision screenings and exams. They are not as robust as vision insurance options you’ll find on the individual market.
Your pet’s age, the pet’s breed and where you live will determine pricing. For instance, as your pet gets older, premiums will increase. And certain breeds carry specific genetic conditions that will also affect your final price.
As far as plans go, the lowest level of pet insurance are typically "accident only" plans. As plans get higher in premium (monthly charge), plans cover a variety of conditions and treatments: hereditary conditions, surgeries, prescriptions, rehabilitative therapies and alternative therapies.
Once you receive a vet bill, you will fill out a claim to submit to your insurance provider. Once that claim is processed, your reimbursement will either be sent to you or deposited directly into your bank account.
The amount of money you receive back will depend on your reimbursement level (70-80-90-100%).
Certain congenital and hereditary conditions are approved for pet coverage. It’s important to check your pet policy to ensure your pet’s condition is accepted. Examples could include hip and elbow dysplasia, luxating patella, cherry eye, IVDD, Wobbler Syndrome, glaucoma and epilepsy.
Some plans do have an annual limit (amount of money allotted per year) that will run out once you have used it. Other plans have an unlimited annual limit that continues to pay you for services and procedures done.
Deductibles vary per plan. The deductible you choose is the amount you will be responsible to pay out of pocket before your pet insurance covers the remaining costs. Choose a deductible that works within your budget if something were to happen to your pet.
A deductible is one of many facets of insurance to consider when you weigh all the costs.