Top 10 Questions to Get the Best Family Dental Plan

By Deborah Pinnock on Jan 8, 2023 @ 03:20 PM

If you are a parent, the love you have for your child is stronger than anything. They’re the reason we work so hard to provide for them. And we strive to protect them. One of the important ways you can do this is by ensuring they have quality health and dental insurance. But it sure can be a struggle to pick the right coverage. That's why it's important to be aware.

Key Takeaways:

Finding the right dental insurance is important for you and your family
It can be a struggle to know what coverage to pick
There are key questions you should be asking your insurance broker
Ask what services the plan covers and if your dentist is in-network
Find out the premium, deductible, and plan maximum
You will be glad you took these steps!

There are so many insurance options and much of it is difficult to understand. After all, you didn’t go to college to get a degree in dental insurance, which is why you have an insurance broker. But even with a broker, you still need to figure out the best coverage for the family, without having to sacrifice the kids’ college fund to pay for it.

To help you make the right decision, here are the top 10 questions you should ask to get the best family dental plan. These are great questions for dental insurance brokers and the answers will help you decide which is the best value plan to choose.

What does the plan cover?

Your youngest has a few cavities, your teen needs braces, plus you and your wife need a few crowns. Do the plans you’re comparing provide coverage for these procedures? Knowing this allows you to narrow down your choices and select the plans that cover the things your family needs.

How much is the annual maximum?

This is important if you’re considering a dental PPO plan. An annual maximum is the dollar amount an insurance company will pay for claims during a certain timeframe. As you consider the number of services you and your family may need it’s important to know the annual maximum amount of the plan. Some plans have unlimited maximums, which may work out better for your family, depending on their needs. Others have rollover benefits program which allows you to carry forward unused benefits to the future.

Does your current general dentist accept the insurance plans you are considering?

Finding the right dentist can be a challenge. So, when you have a general or pediatric dentist that your family has a bond with, it’s natural to stay with them. So, does your dentist accept the insurance plans you are considering? It may be a deal breaker for you.

Do the plans offer both in-network and out-of-network coverage?

The answer relates back to our previous question. If the plan is in-network only, such as a Dental Health Maintenance Organization plan (DHMO), then dental services will only be covered with dentists who are in that plan’s network. If you have a favorite dentist some plans will allow you to nominate your dentist to the network. If the request is approved, problem solved! It’s worth noting, some plans offer consumers the flexibility of in-network and out-of-network coverage (for example DPPO plans). However, you’ll see greater savings when you stay in-network.

Are you required to be assigned to a dentist on a DHMO plan? What’s the process of transferring to another dentist if needed?

A DHMO plan may be a great option for you and your family. It has no deductibles and no annual maximums, and possibly best of all: you don’t have to manage insurance claims. With a traditional DHMO plan, you do have to select and be assigned to a general dentist who participates with the plan. You can change dentists, but you would have to call the insurance company, possibly endure long hold times and then wait about a month or so before you can get seen by the new dentist.

However, all DHMO plans are not created equal. With an open access DHMO plan, you don’t have to be assigned to a dentist. Plus, you can transfer to another in-network dentist as many times throughout the year as you want, without calling the insurance company. So be sure to find out the differences.

Are the dentists who are contracted with your plan easy to get to?

This question depends on how far you are willing to drive to get to a dentist. Ideally, your plan will have dentists close to your home, the kids’ school or your workplace. This will make life easier for all of you. Going to the dentist shouldn’t be a road trip. It would be especially annoying if you have a child with something painful like a tooth ache or if you need to get them to another commitment.

Is preventive dental care covered at 100 percent or close to it?

There’s that saying, “prevention is better than cure.” Most dental insurance companies value and encourage preventive care. So, in most cases you’ll find that routine procedures like office visits, evaluations, x-rays, sealants, space maintainers and routine cleanings are covered at no charge.

Preventive care can lead to early treatment of the leading childhood disease – cavities. On the same note, routine cleanings can help prevent gum disease, which impacts 47.2 percent of U.S. adults, 30 years and older). Taking initiative can reduce the need for more expensive dental work and possible emergency room visits and result in yearly savings.

What’s NOT covered on the plan?

You can truly understand a plan by knowing what it does not cover. These items are usually listed under “Exclusions.” Are there services listed that your family would need? If so, on to the next plan!

Do you have a waiting period before you start using your coverage? If so, how long?

You will want to know if you can start getting dental care immediately once your plan is active. There could be a waiting period. That would mean you and your family must wait before you can use your benefits for some or all dental services. It may come down to deciding if you are okay with delaying your family’s treatment for a certain time.

How much is the premium on your plan?

Once you have narrowed down the plan options that provide coverage for your family needs, then it’s easier to compare premium costs. If the premiums are comparable, then consider whether one plan offers additional benefits. These could include prenatal wellness, oral cancer wellness programs, vision and pharmacy discount plans, and pet medication coverage.

These are all necessary questions for you and your insurance broker to ask. They will help you pick the plan that’s right for your family, without breaking the bank. Ensuring the health and wellbeing of your family is your most important job. Picking the right health and dental plan for them is a key. We hope these tips are helpful.