If you don’t currently have dental insurance, are between jobs, or have questions about getting covered, we can help!
Dental insurance is incredibly important for not only your oral health but also your overall health and well-being. Without it, you may find yourself dealing with unexpected medical or dental bills or in an emergency that could have been prevented by regularly seeing a dentist.
Keep reading to learn how to get dental insurance no matter what situation you are in.
How to get dental insurance: Step by step guide
1. Learn about the value of having dental insurance
Taking the time to sign up for dental insurance may not be a priority if you don’t feel like there’s value to it. That’s why the first step in getting dental insurance is understanding the benefits of it.
Dental insurance provides value by:
- Reducing or covering the cost of dental procedures such as cavity fillings, root canals, etc.
- Increasing the likelihood of going to preventive dental cleaning appointments.
- Improving oral and overall health by early detection and treatment of problems that could become severe.
Tip: Dental insurance is usually provided by a comprehensive benefits package from employers, making it easy to enroll and manage.
2. Determine where your dental insurance will come from
Determining where your dental insurance will come from is the next step in your coverage journey. Most of the time, this will be based on factors such as your place of employment or if you’re self-employed.
If dental coverage is provided by your employer…
If your employer offers dental insurance as part of its benefits package, the premium will often be taken out of your compensation automatically. Most of the time, employers work with one insurance company and employees can either elect to have them as their provider or opt out of coverage.
Getting dental insurance through employer-sponsored benefits is generally seamless when it comes to getting covered. Working with the HR team ensures you are taking full advantage of benefits and aren’t missing out on coverage for you and your family.
If dental coverage is not provided by your employer…
If your employer does not offer dental insurance as part of their benefits package, you will likely have to find other means to get coverage. For most people, this means purchasing individual or family coverage from Delta Dental of New Jersey and Connecticut. This can usually be done online or by contacting us directly.
If you’re currently unemployed…
If you’re currently between jobs or unemployed, you can still get dental insurance by purchasing an individual or family plan from Delta Dental of New Jersey and Connecticut. Like people who work for an employer that does not offer dental insurance, this can be done online or by contacting our customer service team.
3. Find the right dental insurance plan for you
Once you know where your dental insurance will come from, it’s time to find the right dental insurance plan for you.
Note: In some cases, this is determined by your employer, who may have a plan or plans already in place.
The most common dental insurance plans are Preferred Provider Organizations (PPO), Health Maintenance Organization (HMO), Dental Savings Plan, or Managed fee-for-service plans.
Preferred Provider Organizations (PPO)
Preferred Provider Organizations (PPO) are contracted so that members have access to a network of dentists who accept reduced fees for covered services.
PPO members typically have lower out-of-pocket costs when receiving treatment from an in-network dentist because dental insurance companies offering these plans also share a portion of the reduced fee.
The cost that members pay is known as a copay or coinsurance. This is the designated percentage of the reduced fee. The plan then pays the remainder subject to your deductible and annual maximum. Members can receive care from dentists outside of the PPO network but generally have higher out-of-pocket costs in those cases.
Every PPO plan is unique. It’s important to reach out to the individual dental insurance company to understand the specific benefits, network size, and limitations of their PPO plan.
Delta Dental of New Jersey and Connecticut offers these plans under Delta Dental PPO™ & Delta Dental PPO Plus Premier™.
Health Maintenance Organization (HMO)
A dental HMO provides lower cost coverage with a focus on preventive care that typically includes cleanings, periodic oral evaluations, x-rays, and sealants.
HMO plans generally have a smaller network of dentists than that of a PPO, but the cost also tends to be lower.
HMO benefits are provided in exchange for a monthly premium, and members must use in-network dentists to obtain coverage.
Delta Dental of New Jersey and Connecticut offers DHMO dental plans under DeltaCare® USA and Flagship (only in NJ).
Dental Savings Plan
A Dental Savings Plan allows members to choose from participating dentists who charge discounted fees for their services. These plans typically have a lower premium than PPO and Managed fee-for-service plans. Members usually pay an annual amount in exchange for the discounted fees.
Discount plans work differently from most traditional dental insurance plans because there is no reimbursement paperwork to fill out and no coinsurance. Instead, members pay discounted fees directly to the dentist at the time of treatment.
Managed fee-for-service plans
Managed fee-for-service plans usually have the largest network of dentists compared to other dental insurance plans. This means that members generally have higher out-of-pocket costs.
Like PPO plans, members pay a fixed percentage for services provided by an in-network dentist. The Managed fee-for-service plan will then cover the remainder based on your annual maximum and deductible.
Delta Dental of New Jersey and Connecticut offers this plan under Delta Dental Premier®.
4. Consider personal factors
After determining which dental plan makes the most sense for your needs, it’s important to make sure it’s the best fit by considering the following:
Favorite dentist: If you have a dentist that you love and want to keep seeing, be sure to confirm they accept the dental plan you’ve identified before signing up.
Budget: Before signing up for coverage, make sure that it fits into your budget. Most dental insurance companies have upfront pricing or custom quotes available before purchasing a plan.
Read the fine print: It’s important to always take time to figure out what is and is not covered under a dental plan. Some people are surprised to learn that things like cosmetic procedures are not covered by dental insurance.
Don’t wait until the last minute: Don’t get caught in a situation where you need dental insurance but don’t have it. Most of the time, dental insurance companies aren’t able to start coverage immediately, therefore it’s important to get dental insurance as early as possible.
5. Purchase dental insurance
Once you know which dental insurance plan makes the most sense for you, it’s time to purchase coverage.
If your employer offers dental benefits, the cost is usually taken out automatically from your paychecks, therefore you don’t need to worry about making payments as long as you are employed.
Purchasing dental insurance on your own may sound intimidating but it’s easier than most people expect. At Delta Dental of New Jersey and Connecticut, we have online tools where you can sign up for coverage, learn more about costs and benefits, and get answers for other questions you have.
If signing up online isn’t preferred, contacting our sales team is another great way to enroll. Our representatives can answer any questions you have and make sure the dental insurance plan you select is the best fit for you.
6. Schedule your first exam
After you’ve enrolled in dental coverage, it’s time to schedule your first dental checkup! This is a great time to find a dentist, if you don’t have one already, and get your oral health journey started. Often, dental offices will need documents or ID cards to put you in their system. It's a good idea to call ahead of your appointment to see what they need from you.
For more information about dental insurance, check out “What is Open Enrollment?”.
