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Dental Insurance

 

What is dental insurance?

The term “insurance” generally implies a safety-net in case of a worst-case scenario: in the case of car or home insurance, for example, a small regular premium buys the protection of a payout if something serious and expensive happens.  Dental insurance is not like that; in return for affordable premiums your plan  provides financial support for everyday dental needs and should be used fully to ensure that you get the level of treatment and care you require.

 

Normally, you will pay the dentist for your treatment and claim some or all of the cost back from your insurance provider. 

 

When might I need dental insurance?

Although everyone is entitled to treatment by an NHS dentist, finding one isn't easy: and even if you can find one who is taking on new patients, unless you are in the minority who gets free NHS treatment, the costs of dental treatment can be quite high. Regular treatment is essential. However the costs of an unexpected problem or a series of treatments can surprise even those who go regularly to their dentist.

 

What are my entitlements under the National Health Service?

You do not have to pay for NHS dental treatment if, when the treatment starts, you are:

  • aged under 18 
  • under 19 and receiving full-time education 
  • pregnant or have had a baby in the previous 12 months 
  • staying in an NHS hospital and your treatment is carried out by the hospital dentist 
  • an NHS hospital dental service outpatient (however, you may have to pay for your dentures or bridges)

 

You also do not have to pay if, when the treatment starts, you are receiving:

  • Income Support 
  • Income-related Employment and Support Allowance 
  • Income-based Jobseeker’s Allowance 
  • Pension Credit guarantee credit 

 

If you are on a low income you may be eligible for financial help towards the cost of dentistry.

 

NHS dentistry costs fall into three bands:

 

Band 1 course of treatment – £17.50

This covers an examination, diagnosis (eg X-rays), advice on how to prevent future problems, a scale and polish if needed, and application of fluoride varnish or fissure sealant. If you require urgent care, even if your urgent treatment needs more than one appointment to complete, you will only need to pay one Band 1 charge.

 

Band 2 course of treatment – £48.00

This covers everything listed in Band 1 above, plus any further treatment such as fillings, root canal work or if your dentist needs to take out one or more of your teeth.

 

Band 3 course of treatment – £209.00

This covers everything listed in Bands 1 and 2 above, plus crowns, dentures and bridges.

 

What does a dental insurance policy cover?

Every insurer is different and many offer a range of policies, so both cover and premiums can vary widely and it is important to read the policy details carefully.

 

Dental health insurance policies may cover only NHS dental treatments, or both private and NHS dental treatment.  However they often will not pay for the full cost of your treatment. Most policies set maximum payment limits in any 12-month period and some will only pay 75% of the treatment with an annual maximum cap. You will normally have to enrol three to six months before using the plan, but check this with your insurer.

 

Dental insurance will cover general treatment such as fillings, crowns, root canal work, bridges, dentures and other laboratory work up to the maximum annual limits. Emergency treatment is also generally available through dental insurance plans but exclusions may include cosmetic work, orthodontic treatment and implants. 

 

Treatment of oral cancer, surgical removal of roots, treatments on salivary glands and serious dental abscesses may be excluded from your policy so it is very important to check the small print.

 

Are there alternative options?

Dental maintenance or capitation plans

Under dental maintenance or payment plans, in return for annual or monthly payments, you get a care contract/maintenance plan between you and your registered dentist. Where a dental insurer is involved, it is in promoting and selling the plan to individuals and dental practices, and helping the dentist with administration.

 

The maintenance plan allows you to pay a fixed monthly cost for a variety of routine treatments and check ups, including fillings, X-rays and preventive care, but doesn't cover cosmetic dentistry. It may also include supplementary insurance cover towards the cost of treatment required as a result of dental accidents and emergencies. 

 

Individual dentists set their own premium, so the cost will depend on the state of your oral health and how much treatment you need. Some plans insist on remedial work being done before you are accepted for the plan.

 

Maintenance plans are ideal for people with sound teeth, who are prepared to invest in preventative treatment and remedial work. 

Practice Membership Plans

It is becoming increasingly common for dental practices to offer Membership Plans, both for adults and children, with different levels of benefits for different monthly or annual premiums. These plans give you the benefit of having regular visits whilst spreading the cost, making treatment affordable and easy for you to budget. The plans generally offer additional benefits exclusive to members: routine hygienist and checkup visits may be offered as complimentary, with reduced fees for general and cosmetic dentistry treatments.

 

 






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