Dental insurance

Dental insurance is a special insurance plan, which only covers the expenses incurred on dental health and diseases. However, dental insurance also covers only those problems that are deemed emergent or essential by a doctor. Simply put, the dental insurance plan does not cover the cost of any cosmetic dental procedures.

When you make a claim to your insurer, your problem is classified under preventive or diagnostic. Dental insurance plans mainly cover procedures like dental fillings, tooth extractions, implantation of dentures and root canals.

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Dental insurance is quite different from other health insurance plans. It has been designed in many different ways keeping in view the requirements of the customer. If you are thinking of buying a dental insurance plan, then you should know what your requirements are as well as the types of dental insurance policies that are available, as it will help you decide which dental insurance plan is right for you. Below are the differences found in dental insurance plans:

• Certain dental health insurance plans can be opted for as an added benefit to the regular health insurance plan. It contains a list of some dentists where you can claim coverage for dental problems. Not only this, but you can also get treatment from a dentist outside the network of the insurance company - in this case, your out-of-pocket expense increases.
• Some insurance companies prepare separate plans for dental insurance, in which a list of some dental hospitals is given like health insurance. You may get 100% coverage by getting treatment in the hospitals listed by the insurance company or you may have to pay some part of the total amount out-of-pocket as a payment, which completely depends on the conditions of the insurer and policy. However, you cannot get yourself treated at any out-of-network dental hospital.
• Apart from these two, some insurers use a discount method to keep you in their network. If you are insured, you are given a list of dentists where you get a special discount from the company for the treatment. If you get your teeth treated by a dentist who is not on the list, you will not receive the discount.

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Before buying an insurance plan, it is important to know which medical expenses are being covered and which are not covered under it. If you do not know these details, you may have to face problems later on. The applies to dental insurance as well. If you are buying insurance for the health of your teeth, then you should know what all is covered under it. This will ensure that you get the full benefit of the insurance plan you decide to buy.

In dental insurance, every company has its own list of inclusions and exclusions, of which the following are the main ones:

Problems covered in dental insurance plan:

• Any dental disease
• Tooth extraction
• Tooth loss (in an accident)
• Any dental surgery

Problems not covered in dental insurance plan:

• Dental surgery that is not necessary as per the dentist
• Cosmetic procedures (such as whitening)
• Any medicine for teeth that is cosmetic

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The waiting period is a fixed time period, which is given by the insurer to the insured after purchasing the insurance plan. Only after completing this period can you claim any medical expenses from the insurer. Like health insurance, the waiting period in dental insurance is fixed keeping in mind the illness. The longer your teeth need to be treated, the longer your waiting period will be.

For example, if you have minor dental problems that do not require surgery or other major medical procedures, a shorter waiting period is usually given. This is usually because the cost of these treatment procedures is low and the insurer does not suffer financially even if the patient visits the hospital frequently.

Conversely, if there is a serious dental disease that requires major surgery or other medical procedures such as root canals and crowning, the waiting period will be longer. The cost of these procedures is high and the patient has to visit the hospital frequently for them. The waiting period can usually be up to 12 months in such cases.

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When you go out to buy an important product, you try to collect all the information that could help you make a decision about it, whether it is a pair of expensive shoes or a new car. Similarly, before buying a dental insurance plan, it is important to keep some things in mind, so that you don't face a problem later. Below are some of the key points one should keep in mind before buying a dental health insurance plan:

• Deductible: When you have a medical emergency and you go to the hospital, you may have to pay a certain amount out of your pocket, which is called a deductible. So while buying a dental insurance plan, check this amount so you know how much the company asks you to pay yourself while getting any dental treatment done.
• Copayment: Copayment is a  percentage of the total cost of the treatment, decided by the insurer, which the insured has to pay. This is usually applies after paying the deductible amount in case of both conditions. If the company does not apply the deductible, you may have to pay some amount as a copayment.
• Annual maximum: It is important for a person buying a dental insurance plan to keep in mind the amount the insurer can pay as a claim on medical expenses in a year. If the cost of treatment at the time of dental treatment crosses this figure, then you have to pay the remaining amount from your own pocket. Therefore, it is important to find out how much coverage you can get annually.
• Premium: Premium is the major component of any insurance plan. This is the amount that you have to pay every month, quarterly or annually to the insurer. The more the insurer offers you, the higher the premium goes. So while buying a dental insurance plan, keep in mind that the premium of the plan should suit your budget.

There are very few insurers who provide coverage on dental diseases in regular health insurance plans and if they provide dental cover as an additional benefit, the policy premium increases. If you want to buy a health insurance plan, then you can contact myUpchar Bima Plus, which provides you with insurance-related facilities as well as free tele-OPD.

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