816-400-4477Supplemental Dental Insurance
Get the Smiles You Deserve
Premium
A regular payment that must be made on a monthly basis in order to maintain your insurance plan.
Deductible
This refers to the annual sum of money that you are responsible for paying out of pocket for your medical expenses before your insurance coverage begins to provide assistance.
Copay
This is a fixed fee that you are required to pay for each specific healthcare service, such as $10 for a doctor’s visit or $5 for a bottle of medication. The remaining cost beyond this fee will be covered by your insurance.
Co-insurance
This involves a percentage-based payment you are responsible for contributing towards the cost of each health service. For instance, on a 10% coinsurance plan, you would pay 10% of the expenses for each doctor visit, medical procedure, or any other covered healthcare service, while your insurance would cover the remaining portion.
Maximum Out of Pocket
This refers to the maximum limit on out-of-pocket expenses that a consumer can incur for healthcare-related costs within a year. Once this maximum out-of-pocket amount is reached, the insurance company covers 100% of the remaining bills or expenses.
What is Supplemental Dental Insurance?
Navigating the world of health insurance can be confusing and overwhelming. With so many different types of coverage available, understanding what is included and what is not can be a challenge. It’s common for people to have insurance policies without realizing they may not cover certain conditions or types of care. Additionally, being denied coverage for a covered treatment due to circumstantial reasons is also quite common.
When it comes to dental insurance, it can be even more challenging to find a comprehensive plan. Depending on factors such as where you live and your income level, quality dental insurance may be hard to come by. This is where supplemental dental or secondary dental insurance can play a valuable role.
Supplemental dental insurance is designed to fill in the gaps in your existing coverage. These gaps may occur when your primary policy reaches its annual spending limit or when you require treatments that are not covered by your primary policy.
Since many health insurance plans do not include dental coverage, having supplemental dental insurance can be crucial for emergency care and routine maintenance.
Don’t let gaps in your coverage leave you exposed. Consider the benefits of supplemental dental insurance to ensure you have the comprehensive care you deserve.
How Does Supplemental Dental Insurance Work?
When choosing a dental insurance plan, it’s crucial to consider the waiting periods for specific procedures. Some plans may require you to wait between 6 to 18 months before covering major procedures. That’s why it’s important to have dental insurance in place well before you actually need it.
HMO, PPO, and indemnity plans offer a wide range of options in terms of monthly costs, deductibles, and covered services. Make sure to select the plan that best fits your needs.
It’s common for health insurance plans to not include dental coverage, which is why it’s often necessary to have a supplemental policy for emergency care or routine maintenance.
Benefits of Dental Insurance
Depending on Which Plan You Get, These Services Are Usually Covered at the Following Percentages:
Preventive Services
Oral exams, Teeth cleanings, X-rays, Fluoride treatments, and Sealants Coverage – 100%
Basic Services
Fillings, Extractions, Root canals, Periodontal scaling and root planing, Non-routine x-rays
Coverage – 80%
Major Services
Crowns, Bridges, Implants, Orthodontic treatment, Complex oral surgery
Coverage – 50%
Dental Care Options
Dental insurance, similar to other forms of insurance, involves an agreement between you and an insurance provider. In return for a monthly premium, which is a recurring payment made by you, the insurance provider offers coverage for specific dental procedures. Dental insurance generally encompasses three distinct categories, wherein costs are typically covered:
Preventative Care
This refers to dental treatment aimed at identifying and addressing potential issues before they arise, while also equipping you with the necessary tools for self-care. Examples of preventative care include routine check-ups, panoramic X-ray screenings, fluoride treatments for minors, and more. Many dental insurance plans provide comprehensive coverage for preventative care, often covering 100% of the associated costs.
Basic Care
This category encompasses dental treatments that go beyond preventative care but do not involve extensive procedures, specialist involvement, multiple stages, or post-procedural actions required from the patient. Basic care typically involves procedures such as routine cavity fillings or simple tooth extractions. It includes treatments that are not excessively invasive or complex in nature, often comparable to a standard tooth filling.
Major Care
This category encompasses dental treatments that are more extensive, complex, or financially significant compared to basic care. Major care procedures address dental issues that have progressed to a point where they require more comprehensive intervention, despite the possibility of them being resolved earlier at a lower cost. Examples of major services include root canals, dental crowns, or bridges. These treatments often involve more advanced procedures and are intended to address significant dental problems.
Types of Dental Insurance
Dental insurance coverage plans can be categorized into two main types:
Preferred Provider Organization (PPO) Network
PPO plans provide the flexibility to choose any dentist within the approved provider network. These networks consist of dentists approved by your insurance provider to offer dental care to their clients. With a PPO plan, you can receive dental services from out-of-network dentists, but the costs will be higher compared to in-network dentists. By paying your monthly premium, you can access the benefits of a PPO plan, including the ability to select from a wider range of dental providers.
Dental Maintenance Organization (DMO) Network
DMO plans, similar to PPO plans, allow you to see any dentist within the designated provider network by paying only the monthly premium. However, unlike PPO plans, DMOs do not provide coverage if you choose to visit a dentist outside of their network. As a result of this limitation, DMO plans generally have lower monthly premiums compared to PPO plans. These plans offer cost-effective options but require you to stay within the specified network for dental care services.
Finding the Right Dental Insurance For You
Working with a Dental Insurance Broker
When it comes to finding the right dental insurance plan for you and your family, working with a dental insurance broker can be highly beneficial.
Brokers have the expertise to navigate the various options available and help you determine the most suitable plan.
A dental insurance broker offers several advantages.
They can assist you in understanding your benefits, ensuring you get the maximum value for your money. They are knowledgeable about different plans and can help you compare them side by side. Additionally, they can address any questions you may have about your coverage and aid in finding dentists within your network.
Overall, brokers simplify the process and save you time and effort.
Choosing a Dental Insurance Broker
To choose a dental insurance broker, consider their reputation and experience. Seek recommendations from trusted sources such as friends, family, or your dentist. Conduct online research to identify any potential red flags or negative reviews.
Once you have shortlisted a few brokers, schedule appointments to discuss your requirements.
During the meeting, inquire about their experience, specific dental plans they recommend, and the support they provide after enrollment. Discuss their fees as well, as some brokers charge an hourly rate while others receive commissions from insurance companies. Ensure you are comfortable with their fees before proceeding.
Working with a reputable broker can make selecting the right dental insurance plan a much smoother process, eliminating much of the confusion and uncertainty.
It is an important decision that brings peace of mind knowing you and your family are adequately covered. By finding the right broker, you can receive expert guidance and find a plan that aligns with your needs and budget.
States We Are Licensed In For Dental Insurance
Apollo is licensed in 34 states.
These include: Alabama, Arkansas, Arizona, California, Colorado, Florida, Georgia, Iowa, Illinois, Indiana, Kansas, Kentucky, Michigan, Missouri, Mississippi, Montana, North Carolina, Nebraska, New Jersey, New Mexico, Nevada, New York, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Utah, Virginia, Washington, Wisconsin, and Wyoming.
FAQ with Dental Insurance
What if my dentist isn't in my carrier's network?
If your dental provider is not within the network of your dental insurance plan, the available options can vary depending on the type of plan you have.
If you have a PPO (Preferred Provider Organization) plan, you typically have the flexibility to see out-of-network dentists. However, it’s important to note that seeing an out-of-network dentist may result in higher costs.
In such cases, PPO plans often offer discounted rates or reimbursements for services received from out-of-network providers, though the coverage level may be lower compared to in-network providers.
On the other hand, if you do not have a PPO plan or a plan that provides out-of-network coverage, it is advisable to seek dental care from dentists who are within your insurance plan’s network.
In-network dentists have negotiated contracted rates with the insurance company, which can significantly reduce your out-of-pocket expenses and maximize your insurance benefits.
To ensure optimal coverage and minimize costs, it’s recommended to review your dental insurance plan and network directories to find dentists within your network. This way, you can take advantage of the benefits provided by your plan and receive the most affordable care possible.
Why should I choose a network with my carrier?
Choosing a dental network is a critical decision as it offers a range of benefits, including enhanced coverage and discounted pricing.
When you select a dental insurance plan that is affiliated with a specific network of dentists, you gain access to a curated group of providers who have established agreements with the insurance company.
What do I do if I need to see a specialist?
If you require specialized dental treatment, it is advisable to contact your health insurance provider to determine if it falls under their coverage.
What if I move out of state?
It is recommended to contact your provider and inform them of your updated mailing and, if applicable, billing address.
Will I get a plan ID card? Do I need one? How do I use one?
Most insurance carriers issue ID cards to their members.
However, having a physical ID card is not always necessary as long as you have your member ID.
To utilize your dental insurance, you can simply visit the dentist and present your member ID to them.
Factors to Consider When Shopping for Dental Insurance
There are many different dental insurance plans available, so it’s important to compare plans before you choose one.
If you are considering getting dental insurance, there are a few things you should keep in mind:
- The cost of the premium: The cost of the premium will vary depending on the plan you choose. You will need to factor in the cost of the premium when you are deciding whether or not to get dental insurance.
- The deductible: The deductible is the amount of money you have to pay out-of-pocket before your insurance starts to pay. The deductible will vary depending on the plan you choose.
- The coverage limits: The coverage limits are the maximum amount of money that your insurance will pay for dental care. The coverage limits will vary depending on the plan you choose.
- The waiting periods: Some dental insurance plans have waiting periods for certain services. This means that you will have to wait a certain amount of time after enrolling in the plan before you can start using it for those services.
It is important to understand all of the terms and conditions of a dental insurance plan before you enroll. This will help you to make sure that the plan is right for you.
Apollo Will Find The Right Plan For You
Operating since 2010, Apollo Insurance Group is a prominent health insurance brokerage serving Lee’s Summit, Missouri, and Chicago, Illinois.
Our core purpose revolves around making a positive impact on people’s lives. Through our relentless commitment, we strive to unearth the optimal solutions for our valued clients, foster meaningful connections with our employees, and actively contribute to our communities.
With a specialization in Medicare, life insurance, dental, and vision coverage, Apollo boasts a team of knowledgeable agents well-versed in individual health insurance. Allow us to assist you in finding the perfect plan tailored to your needs. Connect with us today by completing our convenient contact form.
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