Dental Insurance Downey, CA
Dental insurance is a form of health insurance designed to cover some of the costs of standard dental care. Fortunately, compared to health insurance, dental insurance is relatively easy to understand. Dental insurance is also available either as a standalone policy or part of a larger medical insurance plan.
If you are looking for a new dental insurance plan, make sure you know the different options before making your final decision. No matter what choice you make, we at Amir Sanjabi Dental are here for you. We are proud to serve patients in Downey and the surrounding area. Call us today at (562) 399-9243 to schedule an appointment or learn more about our services.
How Dental Insurance Works
According to Investopedia, patients should choose a dental insurance plan based on two factors: the network of dentists they want to access and the amount they can afford to pay. Patients can also see dentists who are out of network, but this tends to be a significantly more expensive option. Monthly premiums will vary depending on the patient's insurance company, location, and plan.
There is also a waiting period for most dental insurance policies – usually, around six to 12 months before the patient can have any standard work done. Major work may require longer waiting periods up to two years long. When it comes to dental insurance, there are typically three categories of coverage: preventative, basic, and major. Most plans cover 100% of preventative care, 80% of basic procedures, and 50% of major procedures.
“…patients should choose a dental insurance plan based on two factors: the network of dentists they want to access and the amount they can afford to pay.”
Finding the Right Dental Plan
When selecting a dental insurance plan, people should consider several factors to find a plan that best suits their needs. The first step to finding the right dental plan involves evaluating needs. Young, single adults with good dental health and no family history of oral problems will have different dental insurance needs than a family with a parent who has a family history of gum disease. The likelihood of more frequent visits to the dentist and more extensive treatments indicates the need for a more comprehensive dental insurance policy. Making a generalized list of dental and oral health needs can serve as a good benchmark for evaluating policies and anticipating overall costs.
It is also important to understand the different types of dental insurance plans since each will have varying out-of-pocket costs, benefits, deductibles, and more. Typically dental plans are divided into Preferred Provider Organizations (PPO), Dental Health Maintenance Organization (DHMO), discount dental plans (DDP), and Managed Fee-for-Service Plans. Once people determine the available plans, they should also consider their budget and the covered procedures, waiting periods, and annual limits. Taking the time to evaluate dental needs, budget, and anticipated level of care can make choosing the right dental plan easier.
“When selecting a dental insurance plan, people should consider several factors to find a plan that best suits their needs.”
Dental Coverage
No matter what dental plan a patient chooses, it is essential to double-check what services are included. Some of the most common dental services patients want are routine preventative care and orthodontic services. Though most dental plans cover routine services, they may also require a copay or a fixed amount a patient pays for a health service after meeting their deductible.
However, not all dental plans include coverage for orthodontic services and other specialized services. Therefore, it is imperative to read the details of each plan carefully. Patients who are unsure of the details of their plan should call their insurer to clarify any questions they may have so they are prepared for all scenarios.
“…not all dental plans include coverage for orthodontic services and other specialized services.”
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Affordable Care Act (ACA) Online Enrollment
Dental coverage is available through the Marketplace in two ways: as part of a health plan or on its own as a separate, standalone plan. However, it is essential to note that patients cannot buy a Marketplace dental plan without purchasing a health plan at the same time. Additionally, not every Marketplace health plan includes dental coverage. Purchasing an individual dental plan also necessitates paying another additional premium. While dental coverage is not considered an essential health benefit for adults, it is regarded as an essential health benefit for children.
Marketplace dental plans are split into two categories: high and low. High coverage level plans have lower copays and deductibles but higher premiums. Accordingly, low coverage level plans have higher copayments and deductibles but lower premiums. Comparing dental plans in the Marketplace gives the most details about each plan's copayments, costs, deductibles, and services covered.
“Dental coverage is available through the Marketplace in two ways: as part of a health plan or on its own as a separate, standalone plan.”
Questions Answered on This Page
Q. What factors should people consider when choosing a dental insurance plan?
Q. How does dental insurance work?
Q. How can I tell what is included in my dental coverage?
Q. Is dental coverage available through the ACA Marketplace?
People Also Ask
Q. Is dental insurance worth it?
Q. Can I use my FSA to pay for dental care?
Q. How should people spend and invest their HSA contributions?
Q. What are some of the pros and cons of an HSA?
Q. What is covered under an FSA?
Dental Coverage Through Employers
Most Americans receive their dental coverage through their employers, with most dental plans following the 100-80-50 coverage structure. According to this structure, preventative care is covered at 100%, basic procedures are covered at 80%, and major procedures are covered at 50% or more. However, it is essential to double-check the details of each plan's deductibles (the amount the patient must pay before the carrier begins to pay) and copays (a fixed amount the patient must pay after paying the deductible).
Many individuals also use their flexible spending accounts (FSAs) to cover their dental costs. FSAs are classified as tax-exempt savings accounts, meaning there are no employment or federal income taxes deducted from their contributions. They also have no reporting requirements for federal tax returns. While FSAs cover deductibles and copays for routine dental procedures, they may not cover costs for cosmetic dentistry.
“…it is essential to double-check the details of each plan’s deductibles (the amount the patient must pay before the carrier begins to pay) and copays (a fixed amount the patient must pay after paying the deductible).”
Dental Insurance Fees
Like health insurance plans in the United States, dental insurance plans come with costs, such as deductibles and copays. A deductible is a minimum amount that a person must pay before the insurance policy pays for anything. The deductible will vary depending on the type of dental insurance. Once the patient pays the deductible, their insurance plan will pay for the remaining costs.
Patients may also have to pay a preset amount, called a co-pay, before receiving a service or treatment covered by your insurance provider. The co-pay is usually due to the dentist at the time of the service. People will have to pay it even after they reach their deductible.
“Similar to health insurance plans in the United States, dental insurance plans come with costs.”
Frequently Asked Questions
Q. Is dental health really that important?
A. Yes. Many people mistakenly underestimate the importance of oral health. However, it is intrinsically linked to overall health. Neglecting one's oral health may have disastrous effects overall.
Q. Do I actually need a dental insurance plan?
A. Yes. Dental healthcare can be costly without insurance, especially if you are keeping up with your routine checkups and cleanings. Choosing the right dental insurance plan can help patients afford preventative dental care.
Q. What questions should I ask while looking for the right dental insurance plan for me?
A. There are a few things to keep in mind when looking for dental insurance plans. For example, if you anticipate needing a procedure in the future, make sure to ask whether it will be covered under your insurance. You should also ask if you can see any dentist of your choosing or if you must select one within the provider network, whether you can change dentists once you are enrolled, and how many people the plan will cover. Other pertinent information includes the deductible and copay costs and whether the plan is rated highly by an independent rating firm.
Q. What is a discount dental plan (DDP)?
A. A discount dental plan (DDP) is an untraditional insurance plan where the patient pays the cost of treatment at the contracted rate as determined by the plan. This type of plan does not involve any claim forms. However, patients must make monthly or annual payments to receive care from providers within the dental network at discounted prices and on a set fee schedule.
Q. Who should I talk to about my dental insurance plan's benefits or a claim?
A. Contact your insurance carrier for any questions and concerns you may have about your benefits or claims. They can access your account to review your benefits, claims activity, and eligibility.
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Dental Terminology
Call Us Today
Dental insurance can help you offset the cost of dental care. Amir Sanjabi Dental can help you learn more about what your plan covers. Call us today at 562-399-9243 to learn more about our services or schedule an appointment.
Helpful Related Links
- American Dental Association (ADA). Glossary of Dental Clinical Terms. 2024
- American Academy of Cosmetic Dentistry® (AACD). Home Page. 2024
- WebMD. WebMD’s Oral Care Guide. 2024
About our business, license, and website security
- Amir Sanjabi Dental was established in 2018.
- We accept the following payment methods: American Express, Cash, Check, Discover, MasterCard, and Visa
- We serve patients from the following counties: Los Angeles County
- We serve patients from the following cities: Downey, South Gate, Paramount, Bellflower, Norwalk, Santa Fe Springs, Bell Gardens, Lynwood, Pico Rivera and Whittier
- CA (License #100612). View License Information and Specifics
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