Full coverage dental insurance is often thought of as a safety net that helps you manage the costs of dental care, ensuring that you can maintain your oral health without breaking the bank. But what exactly does it mean when a plan is described as “full coverage”? Let’s take a closer look at what full coverage dental insurance includes, how it works, and whether it’s the right choice for you.
What is Full Coverage Dental Insurance?
Full coverage dental insurance is a term used to describe dental insurance plans that offer a wide range of benefits. These plans typically cover preventive care, such as regular cleanings and checkups, as well as basic and major restorative care, which might include fillings, crowns, bridges, and even orthodontic treatment in some cases. The idea behind full coverage is to provide a comprehensive package that addresses most dental care needs, helping you manage the costs of both routine and unexpected dental treatments.
However, it’s important to note that “full coverage” does not mean that your insurance will fully pay for every dental procedure. Instead, it means that the plan offers coverage for a broad spectrum of dental services, often with the insurer covering a percentage of the cost while you pay the remaining portion.
What Does Full Coverage Dental Insurance Include?
This coverage type is designed to offer extensive coverage across various types of dental care. While the term “full coverage” might suggest that all dental procedures are fully paid for, this is not the case.
Instead, full coverage refers to a plan that provides substantial benefits across several categories of dental care;
Preventive Care
This is the cornerstone of any dental insurance plan, often covered at 100%. Preventive care typically includes bi-annual cleanings, exams, x-rays, and fluoride treatments. The aim is to prevent dental issues before they start or catch them early when they are easier (and cheaper) to treat.
Basic Procedures
These might include fillings, tooth extractions, and periodontal care. Typically, these are covered at a lower percentage than preventive care—often around 70% to 80% of the cost.
Major Procedures
This category covers more complex and costly treatments such as crowns, bridges, dentures, and root canals. Full coverage plans may cover 50% or more of these costs, though significant out-of-pocket expenses can still be expected.
Orthodontics
Some full coverage plans include benefits for orthodontic care, particularly for children. Adult orthodontic coverage is less common and usually comes with limitations.
Cosmetic Dentistry
While cosmetic procedures like teeth whitening are generally not covered by insurance, some full coverage plans may offer partial coverage for cosmetic treatments if they are necessary for dental health.
Annual Maximums and Deductibles
Even with full coverage, most dental plans include an annual maximum—the maximum amount the insurer will pay within a year. Once you exceed this limit, any additional care must be paid for out of pocket. Deductibles are another out-of-pocket expense you must pay before the insurance kicks in.
Related: Dental Insurance Plans – How Does Dental Insurance Work?
Is full coverage dental insurance worth it?
Full coverage dental insurance can be worth it if you anticipate needing extensive dental work or want the peace of mind that comes with knowing most of your dental needs are covered. The key is to weigh the cost of the premiums and out-of-pocket expenses against the potential savings on dental procedures.
Why Full Coverage Dental Insurance is Beneficial
Opting for full-coverage dental insurance has several advantages, including;
- Comprehensive Care: With coverage for a wide range of procedures, you’re less likely to face surprise costs for unexpected dental work.
- Cost Savings: While premiums may be higher, the savings on major procedures can be significant, especially if you require extensive dental care.
- Preventive Focus: Full coverage plans emphasize preventive care, which can help avoid costly procedures in the future.
Potential Drawbacks
However, there are some downsides to consider:
- Higher Premiums: Full coverage plans generally come with higher monthly premiums compared to more basic plans.
- Out-of-Pocket Costs: Despite the name, full coverage doesn’t mean you won’t have out-of-pocket costs. Deductibles, copayments, and the potential to exceed your annual maximum can still lead to significant expenses.
- Waiting Periods: Many full coverage plans include waiting periods for major procedures, meaning you might have to wait several months before the insurance will cover certain treatments.
How Much Does Full Coverage Dental Insurance Cost?
The cost of full coverage dental insurance can vary widely depending on several factors, including the type of plan, the level of coverage, and your location. Here are some of the factors that influence the cost;
Premiums: This is the monthly amount you pay to keep your insurance active. Full coverage plans tend to have higher premiums than more basic plans because they offer more comprehensive benefits.
Deductibles: A deductible is the amount you pay out of pocket before your insurance starts to cover costs. Plans with higher deductibles usually have lower premiums and vice versa.
Co-Insurance: This is the percentage of the cost of a procedure that you pay after you’ve met your deductible. For example, if your plan covers 80% of a filling, you’ll be responsible for the remaining 20%.
Copayments: These are flat fees you pay for certain services, such as a visit to the dentist. Not all plans have copayments, but they are common in Dental HMO (DHMO) plans.
Annual Maximums: Many dental plans have an annual maximum, which is the most the insurance company will pay in a year. Once you reach this limit, you’ll be responsible for any additional costs. Plans with higher annual maximums generally cost more.
Can you get full coverage dental insurance without a waiting period?
Some full coverage plans may offer immediate coverage for preventive care, but it’s less common to find plans that waive waiting periods for major procedures. If you need immediate coverage, be sure to read the plan details carefully.
Does full coverage dental insurance cover cosmetic procedures?
Cosmetic procedures, such as teeth whitening, are usually not covered under full coverage dental insurance. However, some plans might cover procedures that have both cosmetic and functional benefits, such as crowns or veneers.
What if I exceed my plan’s annual maximum?
If you exceed your annual maximum, you’ll be responsible for paying any additional dental costs out of pocket. It’s important to plan your dental care accordingly and understand your plan’s limits.
Conclusion
While it doesn’t cover every expense, it provides substantial protection against the high costs of dental care, making it a valuable option for those who want comprehensive coverage. As with any insurance plan, it’s essential to read the fine print, understand what’s covered and what’s not, and choose a plan that aligns with your needs and budget.
