Dental Insurance: What is it?
Dental Insurance allows you to benefit from agreed prices for the prevention and protection of oral health.
Covering everything from consultations, exams, or dental medicine treatments, dental Insurance includes a set of coverages in the field of oral care that can include access to a stomatology network, assistance services or daily capital for hospitalization.
While the most basic dental insurance policies may only include services such as check-ups, cleanings or minor repairs, the most complete policies may cover implants, braces or surgeries.
Depending on the conditions of the contracted Insurance, pre-existences may or may not be considered and, for some specific care, it is necessary to obtain a pre-authorization from the insurer. It should be noted that at the time of subscription you may be required to complete a medical questionnaire.
Varying from product to product, there may also be grace periods and certain limitations on the insured person’s age.
In this sense, paying attention to the general and specific conditions of the dental Insurance that one intends to take out, namely its exclusions, is essential to guarantee an informed choice that is adequate to the profile and needs of each consumer.
What’s the best dental Insurance for
In order to guarantee the choice of the best dental Insurance, it is not enough just to compare the premiums presented by the different insurance companies, it is also essential to take into account other aspects, particularly the coverage included and the existing copayments in the different care associated with the policy.
Among the set of aspects to be taken into account to determine the best dental Insurance should include the following points:
- More competitive premium compared to the set of coverages included;
- Lower value in copayments (and possibly exemption for some care, namely dental appointments or emergency appointments);
- Lack of grace periods;
- No pre-authorisations required for any care;
- No annual limits for any type of care;
- Smallest set of deletions (such as pre-existing);
- Exemption from completing a medical questionnaire;
- No age limit for membership;
- Free coverage of minor children in the policy and offer of discounts for families;
- Inclusion of additional benefits, such as access to the wellness network.
Before proceeding with the contracting of dental Insurance, it may be useful to carry out a prior check-up in order to be able to define the real needs in terms of possible treatments.
After identifying the requirements that the stomatology insurance must meet, it will then be possible to determine the potential savings with each of the different solutions on the market based on the reimbursement tables made available by the respective insurers .
Perhaps, it may even be the case that an insurer with a higher premium asserts itself as the most competitive if it requires fewer copayments (and eventually includes gratuitous acts) than the competition.
Dental Insurance: how does it work?
Following the contracting of dental Insurance, a dental health card is issued, which must be presented by the insured person to the network’s dental care provider when making the payment.
The amount to be settled, in case the Insurance does not include this coverage without any additional charge for the client, will only be the copayment corresponding to the medical act performed, these charges being previously defined between the agreed providers and the insurer.
Does it pay to take out dental Insurance?
Taking out dental Insurance can allow families to save a lot. However, each consumer must do this analysis individually according to their needs.
Given that there are several solutions on the market whose monthly fee is less than 5 euros and that the cost of a consultation at the dentist can easily be around 40 to 50 euros, this means that it is enough to consult a dentist three times a year so that, even with a possible minimum copayment, the fact of holding the Insurance for teeth is already monetarily compensatory.
For those who have a special need for dental care, such as rehabilitation or corrections, dental Insurance can save hundreds of euros each year.
Generally speaking, it is possible to conclude that dental Insurance is compensatory for those who, due to the need for regular care, consult a dentist more than three times a year, as well as those who plan to undergo expensive treatments in the near future.
Dental Insurance: how does the daily capital per hospital stay work?
Depending on the contracted dental insurance conditions, the capital per hospital stay has a daily limit up to which the insurer contributes to the expenses. Varying from product to product, this coverage may include a maximum limit of days per year and a grace period and/or deductible of a certain number of days per claim.
It should be noted that, in the case of hospitalization in an intensive care unit, there may be a specific value (generally, higher) with regard to the daily capital per hospitalization.
What types of exclusions are there in dental Insurance?
According to the conditions of the contracted dental Insurance, there are a number of situations whose expenses are immediately excluded from the scope of insurance coverage.
Varying from insurer to insurer, among the usual exclusions are illnesses, injuries or pre-existing deformities on the date of conclusion of the insurance contract, as well as accidents at work or accidents arising from participation in sports competitions or the practice of extreme sports.
In this sense, before contracting dental Insurance, it is essential to analyze in detail the specific situations that appear in the list of exclusions.
Dental health plan: is there care that requires prior authorization from the insurer?
Yes, and this varies from product to product, it may happen that for some specific treatments, such as orthodontics or implants, even if they are covered in the dental health plan, it is necessary to obtain prior authorization from the insurer.
Dental plan: what kind of benefits and discounts can be granted by insurers?
Some insurers grant discounts to customers who include several family members in the dental health insurance contract and/or who simultaneously hold other insurance policies contracted with the same company.
On the other hand, there are also insurance companies that allow you to associate children up to a certain age with the dental plan policy at no cost.
Dental health insurance: what is the importance of analyzing the network of agreed providers?
Each insurer makes available to its customers a set of clinics and dentists with which they have an agreement, the so-called network. Through this network, insured persons can benefit from services at a reduced price or even, depending on the insurer and the conditions of the contracted product, free of charge for certain types of care.
The analysis of the network of providers in dental health insurance is especially important for those who do not live in a large urban center, places where, from the outset, it will be easier to access one of the service providers included in the policy’s network, this in order to ensure that you can have effective access to different types of care nearby.
What care may be covered by dental Insurance?
In addition to the most basic care, from check-ups, emergency consultations and scales, dental Insurance may cover a range of specialized treatments depending on the contracted coverage. Among the medical acts that may be included in dental Insurance include:
- Dentistry – resolution of situations of discolored, pigmented, misshapen or fractured teeth;
- Endodontics – treatment of dental pulp pathologies (commonly known as devitalization);
- Implants – placement of artificial teeth in cases of loss of one or more teeth;
- Pediatric Dentistry – oral health care for children up to 16 years of age;
- Orthodontics – treatment of teeth alignment problems through fixed or removable appliances, expanders and extra-oral appliances;
- Periodontology – treatment of gum disease;
- Prosthodontics – rehabilitation or maintenance of function through the use of veneers, crowns and/or dental prostheses.
Best Dental Insurance for Implants: How to Compare Deals?
Firstly, it is important to point out that dental Insurance does not always include coverage for implants. Thus, the first step in comparing dental insurance solutions for implants is to identify which insurers and specific products actually include this type of treatment in dental health insurance.
The second step will be to calculate the costs associated with the different offers, and the value of the dental insurance premium for implants must also be added to the amounts relating to copayments payable by the insured person.
Teeth insurance: what are the differences between general, special and particular conditions?
In dental Insurance, the general conditions refer to the set of clauses that define and regulate the generic and common obligations inherent in the policy, while the special conditions are clauses that, completing or specifying the general conditions, are of general application to certain coverages. , when they were hired. In turn, the particular conditions of stomatology insurance are specific elements of each insurance contract, which are expressed in an individual document.
Dental Insurance: What Is a Copayment? What about claim sharing?
In dental Insurance, the amount borne by the consumer for each act in the insurer’s agreed network is called copayment.
The financing contribution, in turn, designates the cost borne by the insurer in the context of providing agreed care, which is paid directly to the provider.
Dental Insurance for braces: how to choose the best solution on the market?
As with implants, when looking for the best dental Insurance for braces, it is necessary to bear in mind that this coverage is not always included in all products from different insurers. As such, the general and particular conditions of the various policies should be analyzed in detail in order to guarantee the choice of the solution that effectively allows access to the best agreed prices and that includes all the care that will be needed in terms of placement of the dental appliance.
Here, too, it is essential to consider the annual premium and respective copayments when calculating the costs inherent in the different products on the market.
