If you are one of the many people living in Arizona who do not have dental insurance, you may be wondering how you can get coverage. Dental insurance is important for protecting your oral health and preventing expensive dental procedures in the future.
However, many people don’t think about dental insurance until there is a problem. And by then, it’s often too late to get good quality treatment without racking up a huge bill. Dental problems can be very expensive to treat, and sometimes they can even lead to more serious health problems. That’s why it’s important to get dental insurance in Arizona, whether you live in a metro area like Phoenix or somewhere more rural.
In this guide, we will explain what dental insurance is, why you need it, and how to get it in Arizona. We will also provide plenty of information on some of the confusing terms that you may come across, as well as the different types of dental insurance plans available and how much they might cost.
Please keep in mind that this content is written for informational purposes only and should not be construed as medical advice. Always consult with a qualified healthcare provider if you have any additional questions or concerns.
What is Dental Insurance?
Let’s start with the basics. Dental insurance is a type of health insurance that helps you pay for dental procedures. It typically reimburses you for a certain percentage of the cost of dental treatments, and it will usually also cover preventive dental care like exams and cleanings.
Dental insurance is important because it can help you avoid expensive dental procedures down the road. That’s because dental problems often get worse over time, and they can be very costly to treat. By getting dental insurance when you are healthy, you can avoid paying for expensive dental treatments later on.
Why Do You Need Dental Insurance?
Now that we’ve explained what dental insurance is, let’s talk about why you need it. First of all, dental insurance is important for your oral health. Dental problems can lead to cavities, gum disease, and even tooth loss.
Second of all, dental insurance can help you save money on dental procedures. Dental treatments can be very expensive, especially if you have to go to a specialist. By having dental insurance, you can reduce the cost of dental procedures by up to 50%.
Third of all, dental insurance can help you avoid long waiting periods for dental treatments. Many dental procedures have long waiting periods, but by having dental insurance, you may be able to get treated sooner.
Fourth of all, dental insurance helps you maintain your health. Dental problems can sometimes lead to more serious health problems, like heart disease and stroke. By getting dental insurance, you can reduce your risk of developing these health problems.
Who Needs Dental Insurance?
Almost everyone needs dental insurance. Dental insurance is important for both adults and children, and it can help you pay for preventive care and necessary treatments.
Children
Children need dental insurance because they are more likely to develop cavities and other dental problems. It’s important that children have dental insurance to ensure that they have access to quality dental care. Children will typically begin seeing dentists as early as one year old, so they’ll need coverage from a young age.
Anyone with kids will tell you that they also tend to be accident-prone. In fact, dental health experts estimate that up to 50 percent of children will have a tooth injury at some point. Having good dental insurance can come in handy when such an event occurs.
Additionally, more comprehensive dental plans may cover orthodontic care. In fact, about 25 to 50 percent of kids require orthodontics! Thus, a good dental insurance plan can save a lot of money for your family.
Adults
All adults need dental insurance because oral health is linked to overall health. In fact, adults with poor oral health are more likely to have heart disease, stroke, and other health problems. Dental insurance can help you maintain good oral health and improve your overall health.
Seniors
As they age, seniors need dental insurance because they are more likely to have dental problems. Seniors may also need dental insurance to cover the cost of dental care that is not covered by Medicare.
Key Terms for Insurance Plans
Now that we’ve talked about the importance of dental insurance, let’s take a look at some key terms that are important to know when shopping for a plan. This will help you better understand the information provided by the different care plans or your dentist.
Co-Pays
A co-pay is a fixed amount that you have to pay for a dental procedure. For example, you may have to pay $25 for a dental cleaning and $50 for a dental crown. This amount typically applies only to services performed by providers covered within your insurance plan. Otherwise, you may be subject to paying higher out-of-pocket rates.
Out-Of-Pocket
Out-of-pocket dental expenses are the dental care costs that are not covered by dental insurance. You will typically pay for all of your dental care out of your own pocket if you do not have dental insurance. Some dentists will over sliding scales or membership plans to offset these expenses, but they are still typically costlier than paying your insurance premiums and contracted out-of-pocket expenses.
Some dental procedures, such as routine teeth cleanings and X-rays, are typically covered by dental insurance. However, other procedures, such as fillings, crowns, and root canals, may only be partially covered by dental insurance.
You may also have to pay for some or all of your dental care on your own if you choose to see a dentist who is not in your dental plan’s network.
Deductibles
A deductible is the amount of money that you have to pay out-of-pocket before your insurance plan begins to reimburse you. For example, if your deductible is $500, you will have to pay for all dental procedures until you reach $500 in costs. Co-pays typically count toward your deductible.
For example, you may $50 as a co-pay for every dental visit. If you see a dental specialist, the co-pay may be higher, like $75. These expenses you’ve paid go toward a pot, which is your deductible. Once that threshold is hit, because you’ve paid for co-pays and additional services, then your insurance will reimburse at a higher rate.
Premiums
Premiums are the monthly or yearly fees that you have to pay to maintain your dental insurance policy. If you pay for your dental insurance through an employer, they break up the payments and spread them across each pay period.
Annual Maximums
An annual maximum is the maximum amount of money that your insurance company will reimburse you for dental treatments in a year. You may also have a maximum for out-of-pocket expenses, after which point your insurance will cover additional costs. However, unline with health insurance, there is no mandated cap on out-of-pocket costs for adult dental coverage.
Waiting Periods
Waiting periods are the amount of time that you have to wait before your dental insurance policy becomes effective. It’s important to be aware of these dates so you don’t accidentally seek treatment that will not be covered.
Effective Dates
The effective date is the date on which your dental insurance policy goes into effect. Most plans will cover minor pre-existing conditions, such as cavities, right away, even if they were an issue before your plan’s effective date. However, some plans will not provide coverage for more serious pre-existing conditions. Instead, they might impose a waiting period for specific pre-existing conditions. In the worst case, they might not cover them at all at any time.
Coverage
Coverage typically refers to the type of treatments included at no fee or with a co-pay under your plan. It can also be the amount of money that your dental insurance policy will reimburse you for dental treatments.
Types of Dental Insurance Plans
Now that we’ve covered some key terms, let’s take a look at the different types of dental insurance plans available in Arizona. There are three main types of dental insurance plans: indemnity, preferred provider organization (PPO), and health maintenance organization (HMO).
Indemnity Plans
An indemnity plan is a type of dental insurance that allows you to see any dentist that you want. With this type of plan, you typically have to pay a co-pay for each dental procedure and then submit a claim to the insurance company for reimbursement.
PPO Plans
A preferred provider organization (PPO) is a type of dental insurance that allows you to see dentists who are in the network, but it also offers some coverage for procedures done by out-of-network dentists. PPO plans usually have lower premiums than indemnity plans, and they often do not have waiting periods or annual maximums.
HMO Plans
A health maintenance organization (HMO) is a type of dental insurance that requires you to use dentists who are in the network. HMO plans typically have lower premiums and deductibles than PPO plans, but they often have more restrictions. This is a more popular dental insurance plan in areas like Phoenix where there are plenty of providers both in and out of network. However, in rural areas, these restrictions can make it hard to find a reliable provider.
Medicaid
Medicaid is a government-sponsored program that provides dental coverage for low-income individuals and families. In order to qualify, you need to meet certain eligibility criteria.
Supplemental Dental Insurance
You may have heard the term “supplemental dental insurance” thrown around. What is supplemental dental insurance, and what does it offer?
Supplemental dental insurance is a type of policy that helps you pay for dental care that is not covered by your regular dental insurance. This type of policy can be helpful if you need to have expensive dental procedures done or if you want to have coverage for services that are not typically covered by regular dental insurance plans.
There are a variety of supplemental dental insurance policies available, and the cost varies depending on the company that you choose. Some policies may only cover certain procedures, while others may cover a wider range of services. It is important to read the terms and conditions of any supplemental dental insurance policy before you purchase it to make sure that it meets your needs.
If you are looking for supplemental dental insurance, be sure to compare the policies offered by different companies. You should also make sure that the policy you choose covers the procedures that you need.
Group Coverage Versus Individual Policies
When you are looking for dental insurance in Arizona, you may be able to get coverage through your employer or you may have to purchase an individual policy. There are some advantages and disadvantages to both group coverage and individual policies.
Group Coverage
Group coverage is usually less expensive than individual policies because the risk is spread out over a large number of people. However, group coverage typically has more restrictions than individual policies, and it may not cover as many procedures.
Individual Policies
Individual policies are usually more expensive than group coverage, but they often have more comprehensive coverage. Additionally, individual policies also typically have more flexible rules about which dentists you can see and what procedures are covered.
In-Network Versus Out of Network
When you are looking for dental insurance, you may want to consider whether you want an in-network or out-of-network policy. In-network policies typically have lower co-pays and deductibles, but they may not cover as many procedures. Out-of-network policies usually have higher co-pays and deductibles, but they often cover a wider range of dental procedures.
An in-network provider is one who has agreed to accept the terms and conditions of the insurance company. An out-of-network provider is one who has not agreed to accept the terms and conditions of the insurance company. Therefore, since out-of-network providers have not agreed to discounted rates, you will likely pay a higher rate if you visit them
How to Get Dental Insurance in Arizona
There are a few different ways that you can get dental insurance in Arizona. You can purchase an individual policy, you can get coverage through your employer, or you can enroll in Medicaid.
Individual Plans
You can purchase an individual dental insurance plan through companies such as Aetna, Humana, Cigna, or MetLife. In Arizona, Delta Dental is the #1 dental insurance company.
To find a plan, you can visit an insurance company’s website or use a website like eHealthInsurance.com or dentalplans.com to search plans and get quotes.
If you’re looking to purchase an individual dental insurance plan directly from one of these dental insurance companies, you will likely need the following information:
- Zip code of your primary residence
- The names and ages (dates of birth) of everyone you’d like to include in the coverage
- What kind of dental coverage you will need
- How much you are able to pay for premiums each month
Individual policies typically have more comprehensive coverage than group policies, and they often have more flexible rules about which dentists you can see and what procedures are covered.
The cost of individual dental insurance policies varies depending on the company that you purchase from and the type of policy that you choose. The more willing you are to do research and spend time comparing rates, the better deal you’ll likely end up with.
Employee-Sponsored
If your employer offers dental insurance, you may be able to get coverage through them. Some employers require that you pay for dental insurance through payroll deductions, while others offer it for free. Other employers will cover the employee completely, but charge a fee for dependents.
These plans tend to be group plans, and thus more affordable. However, you may find your employer options restrictive, and it never hurts to price our and compare individual plans that may better suit your needs for just a little more money.
Medicaid
Medicaid is a government-sponsored program that provides dental coverage for low-income individuals and families. Qualification for Medicaid requires you to meet certain income restrictions.
If you are unable to get dental insurance through your employer or if you do not qualify for Medicaid, you will need to purchase an individual policy.
The Affordable Care Act (ACA)
As a provision of the Affordable Care Act (ACA), dental coverage is now required as an essential benefit for youngsters under the age of 18, and insurance providers must offer this service.
Thus if you are obtaining medical coverage for your kids, you must be offered a dental policy at the time of purchase. However, unlike medical coverage, you are not required by law to purchase dental coverage, either for your children or yourself. Unlike medical coverage, the ACA doesn’t require everyone have dental insurance, only that children at least be offered coverage. Therefore if you elect not to purchase dental coverage, you won’t be subject to any sort of tax penalty.
How Much Does Dental Insurance in Arizona Cost?
The cost of dental insurance in Arizona varies depending on the type of policy that you purchase and the company that you purchase it from. Individual policies typically have higher premiums than group policies, but they often have more comprehensive coverage. As of 2020, the average dental insurance premium in Arizona was $31.17 per month.
The cost of dental insurance also varies depending on whether you want an in-network or out-of-network policy. In-network policies typically have lower co-pays and deductibles, but they may not cover as many procedures. Out-of-network policies usually have higher co-pays and deductibles, but they often cover a wider range of dental procedures.
When you are looking for dental insurance, be sure to compare the costs and coverage of different policies before you make a decision. You may also want to talk to your dentist about which type of dental insurance would be best for you.
What Services Will Be Covered By Dental Insurance?
Depending on the specific dental plan you select, most regular dental procedures will be covered. However, this may depend on how long you have had your plan and what percentage of certain procedures is covered by your plan.
The cost of dental procedures will vary based on your location and the specific procedure you need. Additionally, if you have a deductible, you will likely have to pay that amount before the insurance covers any other expenses.
Just about all dental insurance plans will cover basic treatments. This includes checkups, X-rays, and regular cleanings – usually twice a year. Depending on your particular plan, you may also be covered in full or partially for:
- Crowns
- Bridges
- Periodontics
- Orthodontia (sometimes)
- Dental implants (sometimes)
- Dentures
- Tooth bonding
Most insurance plans will not cover aesthetic dental treatments. For example, if you have your teeth whitened, get veneers placed, and have gaps fixed, you will likely pay the full cost for those procedures.
Bottom Line on Getting Dental Insurance in Arizona
The bottom line on getting dental insurance in Arizona is that there are a variety of options available to you – and it’s best that you choose one! You can purchase an individual dental insurance policy, get coverage through your employer, or enroll in Medicaid. Always be sure to compare the costs and coverage of different policies before you make a decision. And don’t forget to talk to your dentist about which type of dental insurance would be best for you.
If you are looking for dental insurance in Arizona, we hope you’ll continue to refer to this guide. It will help you to make an informed decision about whether or not dental insurance is right for you! Because purchasing dental insurance is an important way to ensure that you and your family have access to quality dental care to support a healthy lifestyle.