What is dental insurance ?
By 
In this article, we will delve into the fascinating topic of What is dental insurance ?. We will delve into key aspects, analyze relevant data, and discuss significant implications. Whether you are a novice or an expert in this field, you will find useful and engaging information in the following sections.
Introduction
Dental insurance plays a key role in bridging this gap, providing financial protection for procedures not typically covered by standard health insurance or supplemental plans. The launch of 100% Health dental products, effective January 1, 2020, marks an important step in ensuring individuals have access to necessary dental care without financial burden. The scheme will expand to include dentures from January 1, 2021, providing full reimbursement for certain procedures, improving access to essential dental care.
Insurance Dental : What Is It ?
Since January 1, 2020, the 100% Health dental offer allows policyholders to be fully reimbursed by Health Insurance and their supplementary insurance or health insurance for certain treatments. This offer has been extended to dentures (removable prostheses) since January 1, 2021.
Which treatments are covered by 100% Health dental ?
The 100% Health offer gives you access to a wide range of dental treatments, fully reimbursed. It includes:
- Dental crowns : Ceramo-metallic crowns and monobloc ceramic crowns (zirconia and non-zirconia) for visible teeth (incisors, canines, first and second premolars). Metallic crowns for all teeth.
- Dental bridges : Ceramo-metallic bridges for the replacement of an incisor. Fully metallic bridges for all teeth.
- Dentures (removable prostheses) : In resin, for all or part of the teeth, Repairs or changes of elements of dentures.
These dental prostheses are made of materials whose aesthetic and functional quality is adapted to the location of the tooth.
Who is eligible for 100% Health dental ?
Anyone benefiting from a responsible contract through their insurance company (or health insurance) can benefit from the 100% Health dental offer. A responsible contract provides for minimum and maximum coverage levels and currently represents 95% of contracts sold on the market.
How to benefit from it ?
The 100% Health dental offer is available from all dentists. Your dentist will provide you with a quote with a treatment plan specifying the treatments to be performed. There are three baskets for dental prostheses:
- 100% Health Basket : Crowns, bridges, and dentures fully reimbursed if you have a health insurance contract that provides for it (“responsible contract”).
- Basket with controlled rates : Includes crowns, bridges, and dentures whose prices are capped. Moderate out-of-pocket expenses depending on the conditions of your health insurance contract.
- Basket with free rates : Potentially higher out-of-pocket expenses depending on your health insurance contract.
In your dentist’s quote, the proposed treatment and the alternative in the 100% Health basket or, if technically not possible, in the basket with controlled rates must be included. Then, submit this quote to your health insurance company to determine the amount of your reimbursement.
Types of Dental Insurance ?
Dental insurance is crucial for oral health, but how does it work ? Let’s explore the different types of dental coverage and their benefits:
- Preventive Dental Insurance : This category covers preventive dental care, such as annual or semi-annual visits to the dentist for cleanings, X-rays, etc. Most dental plans offer 100% coverage for these services. It’s an excellent way to maintain good oral health and prevent future problems.
- Basic Dental Insurance : Basic care includes common treatments like fillings, extractions, and root canals. Dental insurance plans typically cover a portion of the costs of these procedures. Coverage percentages vary but are often between 70% and 80%.
- Major Dental Insurance : This category involves more complex treatments, such as crowns, bridges, and dental implants. Major insurance plans cover a portion of the costs, usually around 50%. These procedures are often more expensive, but insurance can help reduce the financial burden.
How Does Dental Insurance Work ?
Separate: Unlike some countries where dental insurance is included in health coverage plans, it’s often a standalone policy. Americans need to purchase separate dental insurance to avail these benefits.
Costs and Limits: On average, Americans pay around $360 per year for dental insurance. Plans have an annual maximum benefit or coverage limit, typically between $1,000 and $2,000.
What you need to remember
Dental insurance plays a vital role in solving the financial challenges associated with comprehensive dental care. By covering procedures that are typically excluded from standard health insurance or supplemental insurance, dental insurance ensures individuals receive necessary treatment without causing undue financial burden. The launch of 100% Health dental products from January 1, 2020 is an important milestone in this endeavor. Additionally, the expansion of coverage to include dentures from January 1, 2021 underscores our commitment to improving essential oral health services.
Explore the wide range of dental treatments available at 100% Health, including crowns, bridges and dentures. These fully reimbursed procedures improve aesthetics and function, and promote overall oral health.
