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Things to Consider Before Selecting or Changing your Dental Plan

Before selecting or changing a dental plan ask yourself the following questions:

  • Will employees retain the freedom to choose the dentist they want?
  • What type of routine dental care is covered?
  • What major dental care is covered?
  • How does the plan cover diagnostic and preventive services? Will it cover preventive services such as sealants and fluoride treatments, which may save patients money in the future? Will it provide for full-mouth x-rays?
  • Does the plan cover routine dental care, like crowns, root canals, oral surgery and treatment of periodontal diseases?
  • What major dental care is covered? Does the plan cover dentures, fixed bridges, implants or treatment for temporomandibular disorders?
  • Does the plan cover orthodontic treatment? What limitations are there on age or multiple stage treatment? Is there a lifetime maximum?
  • What limitations does the plan place on pre-existing conditions like missing teeth and existing prostheses?
  • Will the plan allow for care by specialists? Is coverage limited to contracted specialists, or may patients see the specialist of their choice?
  • How does the plan provide for emergency treatment? Is there coverage when a patient must see a non-contracted dentist after hours or while traveling?
  • What proportion of the premium dollars paid by employers or beneficiaries goes to actual treatment? What proportion goes to administrative expenses?
  • Fully-Insured or Self-Insured Plan
  • Cost Sharing
  • Plan Administration
  • Who should be covered under the plan?