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Avoid painful dental bills with insurance

Does the sound of a dentist's drill set your teeth on edge? Consider how much greater your anxiety would be if you had no dental insurance.

Forty-six percent of the population doesn't, according to the National Association of Dental Plans.

Individual coverage is available, but finding the right policy can take a little digging. And, like the group coverage offered through employers, it doesn't always pay for everything.

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Some dental insurance professionals believe that individual policies are more expensive and in some cases less comprehensive than you might get with a group plan. "There's not a big market out there," says Evelyn Ireland, executive director of the National Association of Dental Plans.

Monthly premiums average anywhere from $12 to $50 for one person, according to the association.

Consumers buying their own coverage have to look beyond first-year premium quotes, says Jeff Album, director of public affairs for Delta Dental of California, New York and Pennsylvania. Some companies will offer a great rate for the first year, during which you face a mandatory waiting period for many services. Then the company hikes the rate for the second year.

It's an area that's rife with fraud. Many times the plans are offered by "questionable sources," says Ireland. Her advice: go with employee-sponsored coverage when you can. When you can't, be prepared to do some research to make sure you get both a good company and a good deal.

Both the National Association of Dental Plans and Delta Dental list plans by state. You can also contact an insurance broker or your current insurance carrier. Sometimes the state dental society can tell you what plans are offered in your vicinity. And don't forget your dentist's office. Often they are enrolled in a network or discount plan. Ask which plans or discounts would apply.

Three kinds of coverage
There are three types of dental insurance coverage, says Ireland, and all three should be licensed by your state:

Dental HMOs: Similar to a traditional HMO. You have a limited selection of dentists, but this type of plan offers the best deal in terms of limiting out-of-pocket costs, says Ireland. Premium costs are also likely to be most affordable. The average premium for single coverage: $13 per month, according to the National Association of Dental Plans.

Many times, HMOs will guarantee one or two dentists within 15 miles of home or work, says Album.

HMOs tend to encourage preventative care, so things such as sealants or topical fluoride treatments may be covered for adults, where they might not be on typical PPO or regular insurance plans, says Ireland.

And many times preventative care will be reimbursed at 100 percent, says Album. As treatment gets more restorative and complicated, reimbursement rates can drop to 50 percent or below, he says.

Dental PPOs: If you go to a dentist in the network you'll pay one set of prices. Or you can take a lower reimbursement percentage to see a dentist who is not in the plan. But if you do, expect to front the entire bill until the PPO reimburses you, says Album.

The average monthly premium for single coverage is $30, according to the NADP.

-- Posted: March 22, 2005




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