There are two types of dental coverage that don't have an annual maximum—the dental health maintenance organization (DHMO) and the discount dental plan.
This plan has the lowest monthly premium among Delta's offerings. Look under the hood of these options before making a purchase. You must pay for oral care 100% out-of-pocket from that point forward – at least until the new contract year begins. They want to offer plans with affordable premiums that exceed what they must pay in claims. They do not pay cash benefits. Forecast your expenses based on your treatment plan to avoid running short of money to fix your teeth. They set an annual maximum on the amount they pay for treatment for that particular year of coverage. You will not have this issue with a dental savings plan since there are not any annual maximums. Preventive and non-surgical services are usually covered by PPOs right away. Preventive services such as x-rays, cleanings, and exams are almost 100% covered and important for oral hygiene. Most dental insurance and plan companies have waiting periods that range from six months to twelve months, putting their members in a bad spot during emergencies. There are only a handful of REAL dental insurance plans that have no waiting periods for major services and procedures. HumanaOne Dental Value Plan (DHMO) has a small one-time enrollment fee, no deductible, and no maximum.
This plan is not widely available, so it’s important to search Delta before you get into the details. This means that once you hit that annual maximum, you will no longer have any coverage for the rest of the year and will have to pay out of pocket 100%. Both plans require that patients use in-network dentists. As mentioned previously, most dental insurance plans have no waiting period for preventative and basic services or procedures. Plan providers give members a card which they present to the dentist's office after getting treated. A copayment is a cost-sharing feature that requires the patient to pay a set amount for each procedure. Supplemental insurance is an option for patients who max out their primary plan in any given year. Conversely, your dental plan may have a 6- to 12-month waiting period for restorative services such as filings and non-surgical extractions, where a 12-month waiting period is often standard for major services such as crowns or dentures. After you get your card, all you have to do is to go to the nearest discount dental provider and pay at a discounted rate. In addition, these full coverage dental insurance no waiting period plans have HIGH annual maximums that increase year-over-year and have a big PPO network.
Avoid running out of benefits in a given year if you can.
Obviously, the higher the maximum, the better it is for you—preferably, at the lowest cost. Since the providers don't reimburse for services, members pay their dentists directly.
While regular health insurance policies often have a maximum amount of medical costs that you're obligated to pay out-of-pocket, dental insurance plans often do the opposite. However, there is always an exception to this rule. Careington's site also offers more comprehensive plans as well as an Aetna option. The annual maximum is the yearly limit that any plan will pay in “allowed charges.” Allowed charges are the pre-negotiated fees for specific services rendered by participating providers. It has no yearly limit or waiting period but does impose hefty copayments to discourage excess claims. The good news with a DMO is that you enjoy full coverage with no annual maximum benefit. You simply have to pay a monthly fee for the membership and you can go to your dentist and get discounts. Other services are available for discounted prices (including an up to 25% discount for orthodontia), but these are available only in areas with a Participating Specialty Dentist (PSD). Copyright 2020 by DentalHelps.com | Privacy Policy, Call (800) 311-7092 for Dental Insurance with No Waiting Period. Annual maximum limits what the policy pays in any contract year. Investopedia uses cookies to provide you with a great user experience. Select PPO dental insurance plans feature full coverage and no annual maximum without a waiting period before benefits begin.