This question came from Jennifer, via email.
The answer to this question is a bit tricky, and depends on what’s contained in the plan, and how the benefits are administered.
In short, some medical plans also offer dental coverage. This is separate from a stand-alone dental insurance plan for individual or family. Here are some important questions to consider for medical plans that include a dental benefit:
- Will I need to meet my medical deductible before I can receive dental benefits? In many plans, dental coverage is subject to the individual or family deductible. That means you must pay out of pocket for any non-preventive services you receive, up to the deductible amount, before dental coverage would kick in.
- Is there a maximum covered amount? Most plans include a maximum allowable amount for the plan year, such as $1,000.
- Are there limits or exclusions to coverage? Is coverage only available for adults or children? Is treatment limited in how often it will be covered in a given period (such as once every 3 or 5 years)? Does the coverage exclude certain types of treatment? Some plans exclude major treatment such as root canals or crowns, for example.
- Do I need to see a provider in-network? If the answer is yes, your services may be subject to the out of network deductible and/or lower coverage rates, which is typically higher than the in-network deductible.
Stand-alone dental plans require that you pay a separate monthly premium, which will increase your monthly healthcare costs. However, depending upon how much treatment you or our family members may need, especially major treatments like root canals and crowns, or orthodontics, your total out of pocket expenses may be lower with a separate dental plan.
In addition, many dental plans also cover some or even all preventive services such as routine checkups and cleanings, which can prevent the need for major treatments down the road, and reduce potential (and unexpected) out of pocket costs, saving you money in the long run.
Take a look at this summary of a medical plan with dental benefits included, and our markups: