Dental Insurance Plans in Illinois: Everything You Need to Know

If you’re a resident of Illinois, you may be wondering about your options for dental insurance. Having dental coverage is important for maintaining your oral health and preventing costly dental procedures in the future. In this article, we will discuss the various dental insurance plans available in Illinois, their benefits and drawbacks, and some frequently asked questions.

Types of Dental Insurance Plans in Illinois

There are several types of dental insurance plans available in Illinois. Here are some of the most common ones:

Now, let’s take a closer look at each type of dental insurance plan.

Preferred Provider Organization (PPO)

A PPO dental plan offers more flexibility in terms of choosing a dentist. You are not required to choose a primary care dentist and can visit any dentist within the network. However, if you choose to see an out-of-network dentist, you may have to pay a higher cost.

One advantage of PPO plans is that they offer discounted rates for dental services. This means you can save money on your dental care while still receiving quality treatment. In addition, PPO plans typically have a higher annual maximum benefit, which means you can receive more coverage for your dental treatments.

However, PPO plans also have some drawbacks. The premiums can be higher compared to other dental plans, and you may have to pay a deductible before your coverage begins. In addition, some services may not be covered or may have a waiting period before coverage begins.

Dental Health Maintenance Organization (DHMO)

Unlike PPO plans, DHMO plans require you to choose a primary care dentist from a network of dentists. This dentist will then provide all of your dental care needs, including referrals to specialists if necessary. In addition, DHMO plans typically have lower premiums compared to PPO plans.

One advantage of DHMO plans is that they often cover preventive care services, such as regular cleanings and X-rays, at no cost. This can help you maintain your oral health and prevent more costly dental treatments in the future. In addition, DHMO plans do not require a deductible or waiting period before coverage begins.

However, there are some drawbacks to DHMO plans. You are limited to the network of dentists offered by the plan, and you may not be able to see a specialist without a referral from your primary care dentist. In addition, some services may not be covered, and you may have to pay a copay for certain treatments.

Exclusive Provider Organization (EPO)

An EPO plan is similar to a PPO plan, but with some restrictions. You can only see dentists within the network, and there is no coverage for out-of-network services. However, you do not need a referral to see a specialist, which can be an advantage if you need specialized dental care.

EPO plans often have lower premiums compared to PPO plans, and they also offer discounted rates for dental services. In addition, there is no deductible or waiting period before coverage begins.

However, EPO plans do have some drawbacks. You are limited to the network of dentists offered by the plan, and some services may not be covered. In addition, you may have to pay a copay for certain treatments.

Point of Service (POS)

A POS plan is a combination of a PPO and a DHMO plan. You can choose to see a dentist within the network, or you can see a non-network dentist at a higher cost. If you choose to see a non-network dentist, you may have to pay upfront and then submit a claim for reimbursement.

POS plans often offer discounted rates for dental services, and they also cover preventive care services at no cost. In addition, there is no waiting period before coverage begins.

However, POS plans also have some drawbacks. You may have to choose a primary care dentist within the network, and you may need a referral to see a specialist. In addition, some services may not be covered or may have a waiting period before coverage begins.

FAQ

What is the difference between dental insurance and dental discount plans?

Dental insurance is a type of plan that pays for a portion of your dental treatments. You pay a monthly premium, and in exchange, the insurance company covers a certain percentage of the cost of your dental care. A dental discount plan, on the other hand, offers discounted rates for dental services. You pay a membership fee to the discount plan, and in exchange, you receive discounted rates for dental treatments from participating dentists.

Do dental insurance plans cover cosmetic treatments?

Most dental insurance plans do not cover cosmetic treatments, such as teeth whitening or veneers. However, some plans may cover certain cosmetic procedures if they are medically necessary, such as a dental implant to replace a missing tooth.

Can I change my dental insurance plan?

Yes, you can change your dental insurance plan during the open enrollment period, which is typically in the fall. You can also change your plan if you experience a qualifying life event, such as getting married or having a baby.

What is a waiting period?

A waiting period is a period of time before certain dental services are covered by your insurance plan. For example, some plans may have a six-month waiting period for major treatments, such as root canals or crowns.

How much does dental insurance cost?

The cost of dental insurance varies depending on the plan you choose, your location, and other factors. On average, dental insurance can cost anywhere from $20 to $50 per month.

Conclusion

There are several types of dental insurance plans available in Illinois, each with its own benefits and drawbacks. It is important to carefully consider your dental needs and budget before choosing a plan. By doing so, you can find a plan that meets your needs and helps you maintain good oral health.