What do I Need to Know Before I Purchase Dental Insurance?

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If you don’t have insurance, dental care can be expensive. Most provincial health insurance plans in Canada do not provide coverage for routine dental exams and treatments. As a result, many people do not make regular trips to the dentist, which can lead to serious health consequences down the road.

A Dental Insurance Plan can provide the coverage you need to make visits to the dentist a part of your usual routine so you can maintain a happy and healthy smile for a lifetime. If you’re thinking about purchasing dental insurance to help you defray some of the costs associated with routine dental care, you may be wondering what you need to know before you buy a dental insurance policy.

This list is a good starting point for the questions you need to ask when evaluating your needs for a health and dental insurance plan.

What is Covered?

Different insurance plans offer different levels of coverage for various routine and emergency dental procedures. Some treatments are covered while others are only partially covered. It’s important to know what will and won’t be covered under each plan so you can choose the one that provides the coverage you need.

What Will My Out-of-Pocket Costs Be?

In general, an individual dental insurance plan in Canada pays for a percentage of the costs associated with the services covered under the plan. But what they cover, and how much they cover, can vary considerably from plan to plan.

With the expense of a routine cleaning averaging $150-$200, a seemingly small difference in coverage between plans can make a big difference to your bottom line. So be sure to find out how much coverage your plan provides for every service you will need. Also, some dental insurance plans have deductibles.

If you choose a plan with a deductible, you will be responsible for 100 percent of the costs associated with any dental care you receive until you meet the deductible. After that, the insurance plan will begin paying for part of the cost of treatments covered under the plan.

Other out-of-pocket costs you may have to consider are co-payments or co-insurance. This is the portion of the cost you will have to pay for each dental treatment you receive.

Is there a Waiting Period?

Some carriers have a waiting period before you are eligible for coverage under the plan while others do not. This can apply to any dental treatments, but it’s especially important to investigate coverage options for “Major Services,” which include orthodontia and other options like dentures and crowns. Generally, these major services are not eligible until the third year of coverage under your plan.

Make sure you fully understand your health and dental insurance policy and find out if you have to wait before you can begin receiving dental benefits. It’s the best way to ensure you get the most out of health and dental insurance benefits.

Do Any Services Require Pre-Determination?

Most Canadian dental insurance providers require dentists to complete a pre-determination or pre-treatment form for dental work over a certain dollar amount. In the past, this was a lengthy process that required extensive back-and-forth between the dentist’s office, the insured patient, and the insurance company.

However, technological advances have meant that the pre-determination process is now done electronically, for the most part, and turnaround times are significantly faster than in days gone by.
If you think you may need expensive dental treatment, find out if this is a requirement for the plan(s) you are considering.

Thanks to the introduction of electronic submission for pre-determination forms, this can be completed in almost no time at all.

Choosing the Right Dental Insurance Plan

Choosing the dental insurance plan that is right for you will depend on a number of factors. For example, if you have young children who may need braces in the future, the plan you choose probably won’t be the same as the plan someone who is single with no history of oral health problems chooses. Sorting through the available dental insurance options can be overwhelming, and you may want help deciding which plan is right for you.

Your best option when considering your dental coverage options is to work with a broker. An insurance broker is a knowledgeable professional who can help you better understand the sometimes complex language of insurance, who works on your behalf to match the right customer with the right Canada Dental Insurance Plan.

One of our customer service agents can help you compare the various plans and answer any questions you might have, so you can be sure the plan you choose will provide the coverage you need, when you need it. Contact us today to get started!


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