A typical dental plan provides three levels of benefits after a small (e.g., $50) deductible:
- Diagnostic and preventive services are paid at 100% (deductible usually waived)
- “Basic” services - like simple restorations and fillings - at 80%
- “Major” services at 50%.
Here’s where details matter.
- Does your dental plan cover endodontics and periodontics at the basic (80%) or major (50%) level? The difference in cost is a modest 7%; e.g., $28.88 /month versus $30.09. (Either way, you’ll probably max out your benefit.)
- Does your plan cover implants? (Another 9 %.) Composite fillings? (+3 %.)
- Does your plan have a waiting period for major services?
Dental plans typically have a calendar year benefit limit of $1,000-$2,000. (Hint: if you spent your annual maximum January thru June and your employer switchs carriers July 1, your calendar year limit may be re-set.)
Finally, some plans have a fourth benefit level covering orthodontia at a separate annual or lifetime limit.
FYI: Crowns cost about $1,100 and are covered at 50%. I can thank my corn nuts for knowing that!
P.S. Please watch this ad about “surprise” medical bills, the topic of last week’s Tip. It’s just 30 seconds. (Of
course!)
