Dental and Vision
Choosing Dental Coverage
Proper dental care can be an important component of our well being. As with all insurance-related decisions, there are multiple facets that should go into your decision when purchasing coverage for yourself, family, business, or your employees. And, there are many types of plans to consider such as a PPO (Preferred Provider Organizations), HMO (Health Maintenance Organization), dental indemnity insurance plans, and discount dental plans.
Why it’s important
Dental coverage of some kind can help you ensure the health of your teeth and gums. Unfortunately, if you are bearing the full brunt of the cost of dental care you may find it difficult to pay your dentist bills. Without dental insurance coverage, you may be tempted to skip regular cleanings and checkups, a decision that could lead to serious dental health problems
Types of Dental Insurance Coverage
Similar to medical insurance plans, dental insurance policies are often categorized as either indemnity or managed-care plans. The major differences are concentrated around out-of-pocket costs, choice of dental care providers, and how bills are paid.
Typically, indemnity coverage offers a broader selection of dental care providers than managed-care policies. With an indemnity policy, the carrier pays for covered services only after it receives a bill, which means that you may have to pay up front and then obtain reimbursement from your insurance carrier. Usually, managed-care policies maintain their own dental provider networks. Dentists participating in a network agree to perform services for patients at pre-negotiated rates and usually will submit the claim to the dental insurance company for you.
Basic Dental Insurance Coverage - What is Included?
Understanding what is covered by your dental insurance can be challenging. Coverage differs from policy to policy and from provider to provider. Read the fine print of your policy or agreement to find out what your dental insurance covers. In general, basic dental insurance coverage includes three categories:
1. Preventive and diagnostic dental care: Almost all dental plans and dental insurance policies cover basic dental costs that are meant to prevent dental problems. For the policyholder that means, most plans covers a large part or all the dental costs associated with basic services such as cleaning, checkups, and other dental procedures meant to prevent tooth and gum disease. This coverage is important because it encourages people to seek regular dental care, which can prevent more complicated and costly problems.
2. Basic dental care and dental procedures: Most dental plans and dental insurance also cover basic dental procedures such as fillings, tooth extractions, fixing chipped teeth, and other such basic procedures. However, basic dental care varies from one provider to another. In general, since providers cover a significant portion of basic dental care, it makes sense to select a dental care insurance provider that covers as many dental care basics and procedures as possible.
3. Major dental care: While not all dental insurance plans cover major dental care, some do cover at least a portion of these costs. Major dental care can include procedures such as dental surgery, orthodontics, denture work, and other large, expensive dental procedures. If you will require major dental care at some point in the future you may wish to look for a provider willing to pay for as large a percentage of this type of care as possible.
This is a brief overview of the coverage that can be included in a Dental Insurance policy. You should read a policy thoroughly before purchasing any insurance policy.
Dental and Vision Plans
These companies offer some of the least expensive dental insurance plans in Nevada. Their Maximum Annual Benefits start at $300 and go up to $3,000 with limited coverage for adult orthodontics.
Ameritas Nevada Dental Insurance
Dental Quotes from Delta, Nationwide, Ameritas and Standard life.
Are you looking for a great value in your dental coverage? Ameritas may be the right choice. Insurance coverage on these competitively priced plans starts on Day 1.
The maximum annual benefit starts at $1,000 and goes up to $2,000.
Ameritas has a vast network of dentists in Nevada. Ameritas also includes NO WAITING PERIOD for major services. The percentage of covered cost grows each year you own the policy, so the longer you are enrolled in a dental policy, the lower your cost-sharing will be. This means that the plan will pay out more services in the second and third years than in the first year.
Aware Benefits also offers some great dental plans from other carriers, such as Delta Dental, as well.
How You Benefit from Dental and Vision Plans?
Routine Vision Care
Vision insurance helps cover the cost of routine eye exams, contact lenses and glasses. Some plans also pay for corrective procedures such as laser eye surgery.
Preventative Dental Care
Most dental plans cover preventative and diagnostic care. Additionally, most plans will cover basic dental procedures such as fillings, tooth extractions, fixing chipped teeth, and other such basic procedures.
Real Savings
Dental and vision plans provide you with real savings on care. Besides routine and preventative care, plans will often help you access discounts on other procedures and services.
Vision Insurance: Is It Right For You
At its most basic level, vision insurance helps cover the cost of routine eye exams, contact lenses and glasses. Some vision plans also pay for corrective procedures such as laser eye surgery. Additionally, most plans include one pair of glasses or contacts a year.
Vision care insurance usually covers a percentage of the following basic services:
- Yearly eye examination
- Eyeglass lenses
- Eyeglass frames
- Contact lenses
- LASIK and PRK vision correction procedures at a discounted rate
Your specific vision care plan may have a limit, such as annually or every two years on how often it will pay for lenses and frames.
Frequently, vision care plans (including those you buy or are provided by your employer) contract with eye care professionals. In some plans, you use a certain eye care provider and receive a discount on the services offered. However, most plans purchased from a vision care insurance company are PPOs (preferred provider organizations) where your eye care is managed by a network of eye care providers. In a PPO, you also can use out-of-network eye providers, but you must pay a greater share of the cost.
Typically, eye care offices and networks include optometrists and general ophthalmologists. Some networks also may include ophthalmologists who perform refractive surgery, and provide LASIK or other vision correction procedures.
If you or members of your family wear corrective lenses and need periodic eye exams and changes in your eye lens prescription, it may be worthwhile to purchase vision care insurance. If you do not currently wear or need glasses, you may be able to get a periodic eye exam through your regular health insurance plan.
Frequently Asked Questions
Many people give very little thought to their dental insurance until they need to have something expensive done. I’ve had many clients over the years buy insurance and as soon as the expense is gone, they cancel the policy. It saves the patient money, but an insurance company needs to find some way of mitigating that cost. We do have some great plans available with no waiting period.
The primary challenge for a discount plan occurs when you have a big procedure to do such as a crown or root canal. Typically, either of those will cost about $1500, if you have a 2nd year individual dental plan then insurance will cover 50% of the cost, far more than the discount you’d expect from your dentist. I had one dentist explain to me that her office would discount procedures by 12% to match what the insurance company would pay, using that discount formula your $1500 crown would cost you $570 more than with insurance.
The short answer is because it’s too expensive for the insurance company. Many dental and vision procedures are elective or cosmetic and your medical policy is not designed to improve your health so much as protect you from financial disaster. With a dental plan they cover many procedures that are frankly the more expensive option, like a crown vs extraction. With vision your medical policy would only cover basic glasses instead of the more expensive contacts or multifocal lenses. Your medical policy does cover damage or diseases to the eyes such as glaucoma, and it does cover acute medical damage to the teeth and mouth from accidents.