Solstice Oral & Vision Health Blog

4 Things to Consider when Looking for a Dental Plan

Written by Kate Ranta | May 7, 2014 @ 08:35 PM

Like millions of Americans, you're likely taking a look at your dental plan. Thinking about a new one? Considering changing dental care providers? Keep these four things in mind when looking for a dental plan.

1) Preventative & basic care coverage: You’ll want to find out about the carrier’s preventative and basic care dental coverage. Preventative can include:

  • Regular check-ups
  • Cleanings
  • Fillings
  • Routine X-rays

Basic often includes:

  • Fillings
  • Minor restorative work (such as capping a tooth)
  • Emergency care for tooth/gum pain
  • Non-routine X-rays

Check with your carrier to find out the categories these procedures fall into. And, be aware that the co-pay amounts will vary accordingly. 

2) Emergency & major dental procedures: Another question to consider is the carrier's payment policy for emergency or major dental procedures.

  • Emergency procedures are those not previously scheduled. They can come with a higher co-pay.
  • Major procedures can include pulling teeth, root canals, and bridges.

Sometimes, you might need a last-minute procedure. Or, maybe you require extensive dental surgery, repair work, or the use of local anesthesia. You'll want an idea of costs and co-pays ahead of time.

3) Policy for pre-existing conditions: Most dental (and vision) plans accept the majority of pre-existing conditions. This can include things like missing teeth, etc. However, if you need extensive dental work done, you'll want to find out what, if any, dental conditions are considered pre-existing and not covered by your carrier. 

4) Orthodontia: Unfortunately, not all dental plans cover orthodontia, which treats problems with the teeth through braces, wiring, and brackets. For the plans that do cover it, be aware that there is typically still a lifetime maximum amount that will be covered. Ask questions about limits on the age of eligible members or the complexity of orthodontic work that will be covered to best determine the value of the plan's coverage.

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