An Overview of
DENTAL INSURANCE in Illinois
Dental insurance is still an oft-forgotten aspect of having the coverage you need to live. According to the American Dental Association (ADA), the average cost of dental work was approximately $1624 in 2013, and most people spend $685 out-of-pocket during that time. This implies more than $1,000 may have been covered through dental insurance, but many people do not understand the key differences in types of dental insurance and what it does and does not cover.
What Does Illinois Dental Insurance Cover?
Illinois dental insurance can be purchased to cover many services, ranging from preventative and routine care to major procedures, and added riders may be available to cover extra costs. Some of the common types of dental coverage include the following:
Preventative and Routine Care Are Designed for Those With Good to Excellent Oral Health.
Most insurance policies for dental coverage fall under this category. Preventative and routine care services include dental exams, cleanings, bitewing x-rays, full-mouth or panoramic x-rays, fluoride treatments, space maintainers and sealants. However, certain preventative services, such as maintainers and sealants may only be available to children under certain age limits.
For example, fluoride treatments may be limited to one per person annually while under age 16 or 19.
Most types of insurance cover 100 percent of preventative and routine care services.
Basic Procedures Include Fillings and Simple Extractions and More.
The next step up in dental insurance covers basic procedures, such as fillings, simple extractions, treatment for gum disease, surgical extractions or root canals. However, depending on the policy, surgical extractions and root canals may fall under under a major procedures category and not be covered under a basic policy.
Major Procedure Coverage Varies by Policy.
Any extensive dental procedure can be considered a major procedure, but often, major services include surgical extractions, crowns, bridgework and partial or complete dentures.
Enhanced Benefits May Be Necessary for Illinoisans With Specific Health Conditions.
For some, dental policies may include enhanced benefits. Enhanced benefits provide coverage for people who have specific health conditions, such as high-risk cardiac conditions, pregnancy, diabetes, or suppressed or compromised immune systems. In these cases, an additional insurance rider may be necessary to cover such conditions. Also, and orthodontia rider may be available if orthodontia is deemed medically necessary.
Other Things You Need to Know About Dental Insurance in Illinois.
Aside from the general types of dental services covered, Illinois residents need to understand a few other things about dental insurance policies.
HMO, PPO & Indemnity Plans Are Distinct Types of Plans.
Health maintenance organization (HMO) plans tend to have greater network restrictions, and out-of-pocket maximums and co-pays may be higher when seeing a non-plan network provider. Preferred provider organizations (PPO) have larger networks and tend to have fewer policy limitations. However, PPO plans may be more expensive than HMO plans.
Unlike HMO and PPO plans, indemnity plans, also known as cost-savings plans, provide access to dental services at a reduced rate. However, these plans may have extensive limitations or exclusions for types of dental services covered.
Get the Dental Coverage You Need.
Figuring out what type of dental coverage is best for you and your family can be difficult. Furthermore, some dental insurance agents may offer discounts when purchased in combination with other insurance policies, like health insurance
. So, working with an agent may be the best way to save the most money on dental insurance.
Learn more about dental insurance coverage options in your area by contacting Winters Insurance Group online
or calling 1 (217) 223-4080 today.