Carlton Insurance LLC

Dental care is an important element of total health. Preventive services including dental exams, X-rays and cleanings often save you money over time. Maintaining healthy teeth and gums can help minimize major dental procedures in the future.

With the implementation of the Affordable Care Act, beginning January 1, 2014, there is a requirement in most states for “qualified health plans” to provide “preventive dental and vision” services for children under 19 years of age only. Some states are postponing the implementation of this requirement and others are moving forward in 2014. Depending on the make-up of yourself or your family or the needs & budget of your small business, the decision to purchase dental insurance or not should be carefully considered.

Medicare Dental
As you age, dental costs rise. Depending on your dental history, it may make sense to purchase supplemental dental insurance along with your Medicare MediGap or Medicare Advantage Plan.
Dental insurance for those on Medicare will pay out $500 - $2000/person/year. Most plans do not cover implants but focus on preventive services (e.g., cleanings, exams, X-rays), basic services (e.g., fillings) and major services (e.g., crowns). Each plan has specific definitions for each level of services and it is important to consider these definitions prior to purchase.

In order to determine whether dental insurance is right for you, consider the following questions:
  • How much do I spend on dental services in a year? If I purchase dental insurance, will I at least break even on the premiums I will pay?
  • Is it important to me to visit a particular dentist? Is this dentist in the network of the dental plan?
  • What is the maximum amount of dental coverage provided by the dental insurance plan, per person, per year?
  • Are there any “extras” provided by the dental plan, for example, Vision or Hearing Aid coverage?
  • Are preventive services (typically dental exams, cleanings, X-rays) subject to the annual deductible and covered at 100% from day one of the policy?
  • Which specific services are covered as “preventive,” “basic”, and “major” services for the plans under consideration?
  • Is there a waiting period for any services (typically there is a waiting for major services including crowns, but some plans have waiting periods for more basic services as well)?
  • If I have a Medicare Advantage plan, what is the maximum dental coverage provided by this plan and might I need supplemental dental coverage from a standalone dental plan?

These are just some of the important questions that can arise during your dental insurance purchase decision. If you need assistance in seeking answers to any of these questions or wish to purchase dental insurance, please call or
e-mail me.

This web site may contain concepts that have legal, accounting and tax implications. It is not intended to provide legal, accounting or tax advice. You may wish to consult a competent attorney, tax advisor, or accountant.