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Why are dental and health insurance separate?

Why is that so? Is it possible to combine dental insurance with health insurance? Or do you have to purchase a particular plan?

Dental Insurance

One location that both kids and adults can fear is the dentist. Anyone can become anxious when drilling into their mouth with loud instruments, uncomfortable picks, and needles. However, visiting the dentist is crucial for maintaining our general health. Maintaining good oral hygiene goes beyond simply keeping our breath clean and fresh.

Our memory can be strengthened and our risk of heart disease is reduced when our mouths are kept clean. Your life could be saved by brushing and flossing your teeth. Dental insurance, however, is distinct from health insurance in terms of insurance.

Why is that so? Is it possible to combine dental insurance with health insurance? Or do you have to purchase a particular plan?

Dental Insurance 101

Comparable to your health insurance plan is dental insurance. You pick a provider, a plan, and a monthly cost. Similar to how health insurance is set up, your coverage relies on your plan. Four different types of dental insurance programs exist.

  • Only dentists in your network are covered by your dental health maintenance organization (DHMO).
  • Dentists in and outside of the network are covered by the dental preferred provider organization (DPPO). In-network dentists typically charge less.
  • No matter the network, you can choose any dentist with indemnity plans. Before submitting a reimbursement claim to the insurance company, pay the amount in full.
  • Discount dental plans offer reduced fees and unlimited dental treatment. You must only see dentists in your network and continue to pay a monthly fee.

We pay a premium for health insurance in order to reduce our chance of facing catastrophic medical costs. If you’re young and healthy, you might never need your health insurance. However, dental insurance is more preventative; at the absolute least, it allows you to visit the dentist for cleanings every two years.

As a result, there are four separate categories of services covered by dental insurance. As you advance through the classes of care, your insurance will often pay less and you will be responsible for a larger portion of the costs. While a Class III surgery might only have 50% coverage, a Class I procedure will have full coverage.

The following four types of dental services:

  • Class I – Preventive and diagnostic services (cleanings, exams, X-rays)
  • Class II – Fundamental medical techniques (fillings, root canals)
  • Class III – Major operations and care (crowns, bridges, dentures)
  • Class IV: Orthodontics (braces)

Obamacare: Does It Require Dental Coverage?

The Affordable Care Act does not mandate dental insurance, in contrast to medical insurance. Anyone older than 18 is not deemed to require it. There is no cost to be incurred.

Oral health is regarded as crucial for those under the age of 18. This implies that a child must have access to oral care. You can do this either through your marketplace medical plan or a different plan.

Why Are Dental Insurance Plans Different?

The reasons why dental insurance is excluded from health insurance are the subject of numerous internet rumors. Some believe it has to do with dentistry’s early past, when it wasn’t considered a medical speciality. Some accuse the American Dental Association of not wanting to participate in Medicare and point the finger at them. However, it can be less complicated than that to understand why dental insurance is different from health insurance.

It is quite simple for insurance companies to separate dental insurance from health insurance because it is not regarded as being necessary. Dental insurance is similar to a pre-paid plan because dentistry focuses mostly on preventative care. There are very few circumstances in which having health insurance can shield you from having to pay astronomical prices (i.e. heart surgery). The main reasons dental insurance is distinct are its relatively low cost and non-essential character.

How Can I Obtain Dental Coverage?

There are plans available through the ACA marketplace for adults that include dental insurance. However, it’s more likely that you’ll need to get dental insurance through a third party.

Numerous dental insurance choices can be found by performing a quick Google search. However, you may always talk to an insurance representative if you’d want to find out what your options are.

Like your health insurance, dental insurance is not required. But it’s crucial for your general wellness. To maintain your general health, think about getting dental insurance.