Dental Insurance Plans Pennsylvania: Everything You Need to Know

Having dental insurance can be a big help when it comes to managing the cost of dental procedures. However, finding the right dental insurance plan in Pennsylvania can be overwhelming. In this article, we’ll provide you with all the information you need to know about dental insurance plans in Pennsylvania.

What are Dental Insurance Plans?

Dental insurance plans are policies that help cover the cost of dental procedures. These policies may vary in terms of the types of procedures they cover, the amount they pay out, and the annual limits. In general, there are two types of dental insurance plans: traditional indemnity plans and managed care plans.

Traditional Indemnity Plans

Traditional indemnity plans are fee-for-service plans that allow you to see any dentist you want. These plans typically have higher premiums and higher out-of-pocket costs, but they offer more flexibility in terms of which dentists you can visit.

With traditional indemnity plans, you pay for the service upfront and then submit a claim to your insurance company for reimbursement. Your insurance company will send you a check to cover a portion of the cost of the procedure, usually a percentage of the total cost.

Managed Care Plans

Managed care plans are usually offered by Health Maintenance Organizations (HMOs) or Preferred Provider Organizations (PPOs). These plans typically have lower premiums and lower out-of-pocket costs, but they require you to see dentists who are in-network with your plan.

With managed care plans, you pay a copayment for each visit, and the dentist bills your insurance company for the rest of the cost. Some managed care plans also have annual limits on the amount they will pay out.

Dental Insurance Plans in Pennsylvania

There are several dental insurance plans available in Pennsylvania. Some of the most popular plans include:

Delta Dental PPO

Delta Dental PPO is a popular managed care plan in Pennsylvania. With this plan, you can choose to see any dentist you want, but you’ll pay less out of pocket if you see a dentist who is in-network. Delta Dental PPO also offers a wide range of covered services, including preventative, basic, and major dental procedures.

The annual maximum for Delta Dental PPO is $1,500, which means that the plan will pay up to $1,500 per year for covered dental services. If you go over this amount, you’ll have to pay the additional cost out of pocket.

United Healthcare Dental

United Healthcare Dental is another popular managed care plan in Pennsylvania. With this plan, you’ll need to see a dentist who is in-network to get the best coverage. However, you can still see out-of-network dentists, but you’ll likely pay more out of pocket.

The annual maximum for United Healthcare Dental is $1,250, which means that the plan will pay up to $1,250 per year for covered dental services. If you go over this amount, you’ll have to pay the additional cost out of pocket.

MetLife Dental

MetLife Dental is a traditional indemnity plan that allows you to see any dentist you want. This plan offers a wide range of covered services, including preventative, basic, and major dental procedures.

The annual maximum for MetLife Dental is $2,500, which means that the plan will pay up to $2,500 per year for covered dental services. If you go over this amount, you’ll have to pay the additional cost out of pocket.

FAQs

How do I choose the right dental insurance plan?

The right dental insurance plan for you will depend on your individual needs and budget. Consider factors such as the types of procedures you need, the cost of premiums and out-of-pocket expenses, and which dentists are in-network with each plan.

What types of services are typically covered under dental insurance plans?

Most dental insurance plans cover a range of services, including preventative care (such as cleanings and x-rays), basic procedures (such as fillings and extractions), and major procedures (such as root canals and crowns).

What is the difference between in-network and out-of-network dentists?

In-network dentists have agreed to provide services to patients who are covered under a specific dental insurance plan. Out-of-network dentists have not made this agreement and may charge more for their services.

What is an annual maximum?

An annual maximum is the maximum amount that your dental insurance plan will pay out for covered procedures in a given year. If you go over this amount, you will be responsible for paying the additional cost out of pocket.

Can I use my dental insurance to cover cosmetic procedures?

Most dental insurance plans do not cover cosmetic procedures, such as teeth whitening or veneers. However, some plans may cover procedures that are considered medically necessary.

Conclusion

Having dental insurance can be a valuable asset when it comes to managing the cost of dental procedures. By understanding the types of dental insurance plans available in Pennsylvania, as well as the services they cover and the costs associated with each plan, you can make an informed decision about which plan is right for you.