When selecting a dentist for your child, you have many things to consider. But before you even start looking for a dentist, it is important to understand your child's dental insurance and purchase a plan that will offer the coverage your family needs. Understanding these basic trends in pediatric dental insurance will help you discuss possible treatment plans with your child's dentist.
​Greater Transparency and Comparison Shopping
Since the implementation of the Affordable Care Act in 2014, there have been many changes to both dental and overall health insurance. One of the changes that the American Dental Association noted in their 2015 critique of the insurance marketplace is greater availability of details for consumers looking to purchase pediatric dental insurance. Detailed information about each plan will allow you to better understand how much you will have to pay for standard preventative treatments and what your deductible will be for more intensive treatments.
With this information, you should be able to find the best plan for your family at a reasonable cost. However, to do so you will need to understand a few basic trends in dental insurance.
Embedded Plans vs. Stand-Alone Plans
Currently, parents must select between embedded pediatric dental plans, which are part of their overall health insurance, and stand-alone dental plans, which are purchased separately. When using an embedded plan, the deductible for your child's dental work is part of the overall deductible. This means that if you have a low-cost, high-deductible health insurance plan, you may have to pay for more expensive dental treatments, until you reach your deductible. In this case, you may find it worthwhile to add a stand-alone plan, which will raise your monthly cost but significantly lower your dental deductible.
Alternatively, if you are paying higher premiums to have a low overall deductible or if your child has other health issues and the cost of their health care will consistently go over the deductible each year, then you may save money by using an embedded dental plan.
As a consumer, you should consider what you expect to pay in dental services each year and compare them to your health insurance deductible and the deductible of available stand-alone plans in your area. Your pediatric dentist can tell you if your child is at high risk for extensive dental work based on their current dental health, a family history, and an assessment of their home preventative care.
First Dollar Coverage and Deductibles
Understanding the true cost of dental care can be even more confusing when you add in the concept of first dollar coverage available on many plans. Some embedded plans and many stand-alone plans offer what is known as first dollar coverage for preventative care. This means that regular dental visits such as check-ups and cleanings will be immediately covered by your insurance, even if you have not reached the minimum stated as your deductible.
With most first dollar coverage plans, restorative procedures, such as fillings and crowns, are applied to your deductible. It is important for you to understand exactly which procedures are part of your first dollar coverage and which ones are tied to your deductible before you make a decision regarding the best insurance for your family.
Higher Availability of More Expensive Treatment Options
With changes happening in the insurance market, there are also many changes happening in pediatric dentistry that can affect the cost of your insurance and the amount you will pay directly for your child's dental care. Many pediatric dentists are choosing to offer more technologically advanced and comfortable pediatric treatments at a higher cost than traditional pediatric dentistry.
New instruments are being used to make visits shorter and more effective. Also, sedation dentistry and fast-working anesthetics are making pediatric dentistry easier for children, parents, and dentists. If you are interested in taking advantage of these advances in pediatric dentistry, it is important to find a plan that will cover the treatments you intend to utilize.
Understanding your insurance plan will allow you and your dentist to create an affordable treatment plan for both restorative and preventative care for your child, resulting in their better oral health. If you have specific questions about dental procedures and treatment plans, talk with a dentist at a clinic like Kids First Pediatric Dentistry
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