Dental insurance is not typically included with your major medical policy, so you usually have to purchase it separately as a supplemental plan. The kind you select will affect your choice of dental care providers, out-of-pocket costs, and how your bills are paid, so it’s crucial to select the right type of dental insurance for you. Continue reading to learn more about supplemental dental insurance and how it can benefit you.

 Primary Dental Insurance vs. Supplemental Dental Insurance

Primary dental insurance is the main source of dental coverage, catering to routine dental care and basic services like cleanings, exams, and fillings. It focuses on preventive and diagnostic treatments, helping individuals maintain their dental health with regular check-ups and essential procedures.

On the other hand, supplemental dental insurance offers additional coverage beyond the primary plan. It fills in the gaps in coverage and provides benefits for more extensive or specialized dental treatments such as root canals, dental implants, and orthodontics. By combining both types of insurance, individuals can enjoy comprehensive dental coverage, ensuring they have access to essential preventive services while also receiving financial support for more complex dental procedures.

 What is primary dental insurance?

Primary dental insurance refers to the main dental insurance policy that individuals obtain to cover their routine dental care and basic dental services. It is the primary source of coverage for dental treatments and services. In a primary dental insurance plan, individuals typically pay a monthly premium, and the plan covers a certain percentage of the cost for routine dental procedures such as cleanings, exams, X-rays, and basic fillings. Primary dental insurance helps individuals maintain their dental health by providing coverage for essential preventive and diagnostic services.

What is supplemental dental insurance?

Supplemental dental insurance is designed to fill in gaps in a policy holder’s existing dental coverage. These gaps can arise when a primary policy meets its annual spending cap or when certain treatments and procedures are needed but not covered.

Many health insurance plans lack dental insurance, often making a supplemental policy necessary for emergency care or for regular maintenance.

How does primary and supplemental dental insurance work together?

When a primary plan covers only part of your expenses, a supplemental plan can help cover some or all of your costs. For example, if you have a procedure that will cost you $1000, and your existing policy will pay only half of that, a supplemental plan can be used to help with the rest.

Once your primary plan has paid all that it will pay, a supplemental policy will then be able to be applied to pay in part or in full for the remainder. Supplemental dental insurance tends to provide a given amount of coverage for certain types of procedures and care, just as primary plans do.

Before purchasing a specific supplemental plan, it is best to talk with a broker to learn whether or not the care you want to be covered will be. There are different supplemental plans for different types of dental care and different circumstances.

 Advantages of Supplemental Dental Insurance

Supplemental dental insurance offers several advantages that complement primary dental coverage and provide additional benefits for individuals. Some advantages include extended coverage, reduced out-of-pocket costs for specialized treatments, flexibility in plan options, and complementary coverage to enhance and support primary dental insurance. These advantages make supplemental dental insurance a valuable addition to ensure comprehensive dental care and financial protection for a variety of dental needs.

 Enhanced Coverage for Specific Procedures

One of the significant advantages of supplemental dental insurance is its enhanced coverage for specific procedures. While primary dental insurance usually covers routine dental care and basic services, supplemental insurance extends coverage to include more specialized and costly treatments. Procedures such as orthodontics (braces), dental implants, crowns, bridges, and root canals are often covered by supplemental dental insurance.

By offering extra benefits for these specialized treatments, supplemental dental insurance helps individuals manage the high costs associated with these procedures. It reduces the financial burden and ensures that individuals can access the dental care they need without worrying about excessive out-of-pocket expenses. This enhanced coverage is particularly beneficial for those with specific dental concerns or ongoing dental issues that may require more advanced treatments.

 Lower Out-of-Pocket Expenses

Supplemental dental insurance, particularly with a managed-care dental plan, offers the advantage of lower out-of-pocket expenses. Managed-care plans negotiate lower fees with participating dentists, resulting in reduced rates for covered treatments and pre-determined copayments. Policyholders can benefit from streamlined paperwork, a network of in-network providers, and a focus on preventive care, leading to more accessible and cost-effective dental treatments while maintaining oral health.

 Flexibility and Customization

Supplemental dental insurance provides the advantage of flexibility and customization, allowing individuals to tailor their coverage according to their specific needs. One notable option is the indemnity plan, which offers a broader choice of dentists. With an indemnity plan, policyholders have the freedom to visit any licensed dentist of their choice, regardless of whether they are in the plan’s network. This flexibility ensures that individuals can continue seeing their preferred dentist or access specialized dental providers, without the restrictions of staying within a specific network. Moreover, the indemnity plan reimburses policyholders for a portion of their dental expenses, giving them the freedom to manage their dental care and budget according to their preferences and oral health requirements. This level of customization empowers individuals to make informed decisions about their dental care and choose the providers and treatments that best suit their needs and preferences.

 Additional Benefits and Services

Supplemental dental insurance offers additional benefits and services beyond primary dental coverage. These advantages can enhance dental care and provide added value for policyholders. Common benefits include coverage for orthodontic treatments, dental implants, and cosmetic dentistry. Some plans also offer dental emergency coverage, extra preventive services, and increased annual maximums. With these additional benefits, individuals can enjoy a more comprehensive and tailored dental insurance plan, addressing their specific dental needs and providing greater peace of mind for their oral health.

Types of supplemental dental plans

HMO, PPO, and indemnity plans provide a great deal of options when it comes to monthly costs, deductibles, and covered services. Be sure to choose the plan that best meets your needs.

Indemnity plans

Indemnity plans offer a broader selection of dental-care providers than managed-care plans. Indemnity plans pay their share of the costs for covered services only after they receive a bill (which means that you may have to pay all of the costs up front and then bill your insurance company, which then reimburses you for covered charges).

Managed care plans

Managed-care plans typically require you to use a dental provider network. Dentists participating in a network agree to perform services for patients at pre-negotiated rates and usually submit the claim to the dental insurance company for you. Managed care plans typically come in two varieties: health maintenance organization plans (HMOs) and preferred provider organization plans (PPOs).

Dental services covered by supplemental dental plans

Depending on the dental plan you select, many regular dental procedures may be covered. This can also depend on how long you have had your plan and what percentage of certain procedures is covered by your plan.

The cost of dental procedures also varies according to your location and the type of procedure you need. If you have a deductible, you normally have to pay that amount before the insurance company covers any benefits.

Nearly all dental insurance plans cover basic treatments such as checkups, X-rays, and cleanings. Depending on your plan, you may also be covered in full or partially for:

• Crowns
• Bridges
• Periodontics
• Orthodontia (in some cases)
• Dental implants (in some cases)
• Dentures
• Tooth bonding

Cosmetic treatments typically aren’t covered by most insurance plans. For instance, you can have your teeth whitened, veneers placed, and gaps fixed, but you will likely pay the full cost for those procedures.

Who Can Benefit from Supplemental Dental Insurance?

Supplemental dental insurance can be beneficial for various audiences, offering additional coverage and advantages that complement primary dental insurance plans. Whether you have specific dental needs, require specialized treatments, or seek financial protection for dental emergencies, supplemental dental insurance can provide added value and peace of mind.

Individuals and Families with Limited Dental Coverage

Individuals and families with limited dental coverage from their primary insurance can benefit from supplemental dental insurance. This audience often faces restrictions in their primary plan, such as waiting periods for certain treatments or limited coverage for specialized procedures. Supplemental dental insurance can fill these gaps and offer additional coverage for services like orthodontics, dental implants, and cosmetic dentistry. It provides peace of mind and financial support for various dental needs, ensuring comprehensive dental care without the burden of high out-of-pocket expenses.

 Seniors on Medicare

Seniors on Medicare can find value in supplemental dental insurance as Medicare typically does not cover routine dental care. With supplemental coverage, seniors can access preventive services like cleanings and exams, as well as specialized treatments such as dentures or dental implants. This can significantly improve oral health and overall well-being for seniors, reducing the risk of dental problems and allowing them to maintain a healthy smile in their golden years.

Employees with Basic Dental Benefits

Employees who have basic dental benefits through their employers can benefit from supplemental dental insurance to enhance their existing coverage. While basic dental benefits often cover routine care, supplemental plans can extend coverage for more complex and costly treatments. This can be advantageous for employees who may require orthodontic treatments, cosmetic procedures, or additional cleanings and exams. With supplemental dental insurance, employees can optimize their dental coverage to suit their specific dental needs and preferences.

College Students and Young Adults

College students and young adults, especially those who are no longer covered under their parents’ dental insurance, can benefit from supplemental dental insurance. This audience may face specific dental challenges, such as the need for orthodontic treatments or managing the costs of dental emergencies away from home. Supplemental dental insurance can provide the necessary coverage and financial protection to address their dental needs during this transitional phase of life, ensuring they maintain good oral health as they start their independent journey.

How can you qualify for supplemental dental insurance?

If you need dental coverage and discover unexpectedly that your employer insurance or other policy does not cover it, it can be rather alarming. In this event, your first move should be to talk with a supplemental insurance provider.

In order to be eligible for supplemental dental care benefits, you need to resolve any possible conflicts between existing coverage and the coverage the dental coverage you are seeking would provide. For example, a supplemental plan will not accept a claim until after your primary plan has paid all that it is scheduled to pay for it.

If you are waiting for a coverage period to arrive, chances are good that you will qualify for supplemental coverage in the interim. If you are on Medicare and live in a state where Medicare does not cover dental, supplemental coverage might be the best choice. What’s important is that the two policies are not active and ready to pay at the same time. This is known as the coordination of benefits.

Dental coverage and Obamacare

With the implementation of the Affordable Care Act (ACA), also known as Obamacare, dental coverage is considered an essential benefit for children under the age of 18 and insurance companies are required to offer this coverage for kids.

This means that if you are obtaining medical coverage for your kids, you must be offered a dental policy to purchase at the same time.

However, you are not required to purchase dental coverage, either for your children or yourself. Obamacare doesn’t require that everyone have dental insurance, only that children be offered coverage. So you won’t be subject to the tax penalty if you and your family decide not to enroll in dental coverage.

Why you might need a dental insurance plan

By purchasing supplemental dental insurance, you are safeguarding your and your family’s health, as well as your finances. If you want to further explore your dental insurance options, please visit our dental insurance page to compare all of the different plans available.