 Personal Finance PowerPoint Presentation. Dental insurance and dentures. Prepare to get financially fit by practicing personal finance. Insurance is part of our long-term risk mitigation strategy where we use the adage of measure twice, cut once, going through a formal process, looking something like setting up the goals, develop the plan to reach the goals, put the plan in action, review the results, repeat the process periodically. We're now looking at the dental insurance and dentures. Most of this can be found at Investopedia. Does dental insurance cover dentures, which you can find online? Take a look at the references, resources, continue your research from there. This is by Matt Danielson, updated August 31st, 2020. Does dental insurance cover dentures? So we've been talking about insurance in general and prior presentations. We moved on to the medical insurance, which can be a little bit more complex given the fact that the medical insurance industry in and of itself is complex. Because of the regulations involving it and the insurance related to it, the dental insurance kind of has some more components of it that are similar to the medical insurance. So now we're drilling down a bit deeper on some specific items with regards to the dental insurance. Most full dental insurance policies include some restorative coverage, usually meaning that up to 50% of the cost of dentures is covered. So we talked about some of the different categories with regards to most dental insurance, noting that the normal kind of wear and tear or the types of procedures on the dental are usually kind of easier to define than just a medical field in general, where you can of course have a problem, you go to a specialist, but you don't know exactly what to do sometimes. Whereas the dental, you can usually kind of categorize them out. So we went to some of those categories in prior presentations. This is usually gonna be one of the ones that could be a more expensive area and where you've got that 50% of the cost here. So regular deductibles and copays still apply. So the actual cost to the patient is always a substantial amount. What does dental insurance typically cover? Dental insurance has a typical annual maximum coverage cap amounting to a medium of $1,500. Now remember, this is kind of different than what you might think of for traditional insurance, like life insurance or property insurance or liability insurance and to some degree medical insurance where you might be saying, hey, there's some event that could possibly happen out there in the future that would be very financially devastating, although it might not happen like my home burning down or me getting sued or something like that. So I want to have insurance to cover me in the event that that big thing kind of happens. So you got the deductible oftentimes and you think about over the deductible, the insurance kind of kicks in up to a fairly high amount possibly covering like the property if it was for a home or something like that. With the medical insurance, you have a similar thing with the out-of-pocket maximum. With the dental insurance, it's a little bit different because they have a fairly low amount that the insurance oftentimes will be paying before you have to pay over and above that amount, which can clearly be lower than what a substantial problem that could be covered for the dentistry could have. So you got to keep that in mind when you talk about more kind of expensive procedures. So 1,500 is the medium kind of like the mean, but like in the middle, you know, the average, but no, it's the medium, the one in the middle. It covers procedures strictly related to health and wellness and it has a three-tier structure known as 18050. Preventative care such as annual cleaning, x-rays and sealants is covered 100%. So here we've got the categorizations. So the preventative stuff is the stuff often covered. And then the basic procedures such as fillings, extracts and periodontal treatment for gum disease are covered 80%. Major procedures, that's the crowns, the bridges, inlays and dentures are covered 50%. Depending on your plan, root canals can fall into either the basic or major category. Most plans focus on preventative and basic care and not all procedures are covered. So limitations of dental insurance. Most insurance companies have a waiting period for new patients, though there are some that don't. So in other words, if you're looking for some of these bigger kind of things, remember that you can't really wait until the problem happens and then get the insurance that defeats kind of the point of traditional insurance, meaning you can't get car insurance after you got in the car accident to cover the car accident that's just got into. It's kind of similar with the dental insurance, but they don't wanna get into the preexisting conditions and screening and that kind of stuff. So they do something a little bit tricky here. Basically wait until the insurance will kick in for certain procedures because typically if there's a problem with the dental kind of thing, you're gonna need to get it fixed fairly soon or else you're gonna be going through pain and it's gonna get worse through that timeframe. So that's how they do it. So this waiting period usually applies to non-emergency procedures such as dentures and typically ranges anywhere from a few to 12 months, though it can be as long as two years for some companies, annual coverage limits, which can be as low as $1,000 despite the medium mentioned above, which was 1,500 I believe, can result in a situation where a loss filling or cavity earlier in the year has already eaten up a large portion of that year's dental allowance. So we talked about the fact that it might be covered only to 50%, but you could also have things that were covered to some degree by the insurance company hitting that fairly low cap, the amount that the insurance will be paying out fairly quickly given the cost of the dental procedures. So this would likely result in dentures being covered at less than 50%. So we have to be strategic about when you plan for certain procedures. Some employer dental insurance packages have an option for lower monthly costs but may offer little to no coverage for restorative procedures. Patients must foot the entire bill for dentures in these cases. If it is possible to wait, it may be wise to switch providers during open enrollment to an option that includes denture coverage as the savings can easily outweigh the higher monthly costs. Discount plans, discount dental plans are not insurance. They represent a group that has negotiated discounts and fixed prices for specific dental procedures at a limited number of dental professionals in the area. So those lacking dental insurance altogether and those with limited coverage insurance may find savings of up to anywhere from 15% to 50% compared with regular prices. Your discount is given at the time you have your procedure and you must pay at that time because annual coverage limits generally top out at $1,500 while dentures usually start at $2,500 for an upper or lower plate. You will end up paying a large amount out of pocket when using dental insurance to get the dentures. So no matter how you cut it, you got that 50% that you might be looking at that you have to pay. And then you've got the cap that is fairly low that the amount that the insurance company will pay out. So you gotta take those into consideration when doing your calculation. So discount dental plans have no waiting period or annual coverage limits. So if you can find the right plan, you may do better using one of them to pay for dentures rather than using dental insurance according to dentalplans.com. Before signing up for a discount dental plan, make sure that the coverage meets your needs. Also check that the participating dentists in the area do not have prehabilitative long waiting lists for new patients.