Dental Insurance for Kids – How to Find the Right Plan

Regular dental care for kids is essential for maintaining overall health and preventing long-term dental problems. However, dental care for kids can be quite expensive.

The right dental insurance plan significantly reduces costs, enabling easy dental care access whenever needed. There are many dental insurance plans for kids, but the right one depends on your child’s needs, costs, and terms and conditions.

This article will offer guidance on finding the right dental insurance for kids by discussing the factors to consider when choosing a plan.

Factors to Consider When Choosing Dental Insurance Plan for Kids

The right dental insurance plan varies from child to child. Below is a look at the factors to consider when determining the right dental insurance plan for kids.

Your Kid’s Dental Care Needs

Kids’ dental care needs vary depending on their dental health status, oral hygiene habits, diet, age, and genetics. Whereby some kids might require more regular visits to the dentists than others. Also, others may require extensive treatments, while others only require routine visits to the dentist.

Below is a look at the most common dental health care for kids:

• Preventative care. It includes regular visits to the dentist for check-ups, cleaning, and fluoride treatments to ensure optimal dental health and help prevent cavities, gum disease, and other dental problems. Preventative dental care can also include the use of sealants to protect molars and premolars from cavities.
• Fillings. Some kids develop cavities that may require dental fillings to repair or restore damaged teeth.
• Extractions. Kids require dental services to extract milk teeth on time and pave the way for permanent teeth to come up. In other cases, teeth that have developed cavities may be too damaged or infected for restoration, requiring extraction.
• Orthodontics. Orthodontic treatment is designed to help straighten teeth and correct bite problems in kids. They include the use of braces or retainers. Orthodontics can be particularly expensive, so having dental insurance coverage in place can significantly reduce your cost.
• Emergency dental care. Kids may require emergency dental care for different reasons, e.g., broken tooth or severe toothache.

Type of Plan

There are different types of dental insurance plans for kids. One of the most crucial steps for finding the right dental insurance plan for children is to understand the different types of plans available. Below is an overview of the most common types:

• Dental HMO (Health Maintenance Organization) plans. These plans require that your dentist refer you for specialty care or treatment. They usually have a small network of providers.
• Dental PPO (Preferred Provider Organization) plans. Unlike DMOs, dental PPOs have a larger network of providers. You also do not have to be referred for specialty care.
• Dental fee-for-service plans. With these plans, your child can be seen by any dentist, as no network of providers is stipulated. However, they tend to have higher out-of-pocket costs.
• Dental Medicaid plans. Medicaid is a government-funded healthcare plan that provides Medicare coverage for low-income families. The plan includes dental coverage for children from low-income families.
• Children’s Health Insurance Program (CHIP). It is a federal and state-sponsored children’s health insurance program for middle-income families that do not qualify for Medicaid but cannot afford private insurance. It is comprehensive coverage that covers dental care for kids and a wide range of medical services, including check-ups, doctor’s visits, hospitalization, prescription drugs, and immunization.
• Stand-alone dental plans: These are purchased separately from comprehensive medical insurance plans.
• Dental discount plans. It is a flexible and affordable method of paying for dental care costs. You are required to pay an annual fee to access different dental procedures. There is no specified network of providers.
• Child-only dental insurance plans. These plans are specifically designed for children and may have different benefits and coverage limits than plans that cover adults.
• Family dental insurance plans. These plans cover multiple family members, including children, and may have different benefits and coverage limits than individual plans.
• Dental insurance for children with special needs. These plans are specially designed to offer dental coverage for children with special needs.
• Dental indemnity plan. You can see any licensed dentist with this type of dental coverage plan. However, they have higher monthly premiums.

Scope of Coverage

When assessing if a given dental coverage is right for you, consider its scope of coverage and whether it caters to your kids’ healthcare needs.

The right cover should at least cover regular check-ups, preventative care, basic treatment procedures such as sealants, fillings, extractions, and common major treatments such as root canals, crowns, and bridges.

The plan should also cover orthodontic treatments if your child has orthodontic treatment needs. Note that some plans have a waiting period for various dental treatment procedures.

Costs

Payable monthly premiums and additional costs for insurance for kids vary from plan to plan. The exact cost depends on factors such as the child’s age, their dental care needs, the type of insurance plan, its coverage level and the insurance provider.

On average, the monthly premium for dental insurance for kids ranges between $10 to $40. Additional costs such as deductibles, copays, and co-insurance apply. Compare different plans to identify those that fit your budget.

Financing Options

If your budget is tight, there are several financing options that you might want to consider. Some allow you to afford dental health care for kids more affordably, while others are financial assistance programs that help you pay for your child’s dental insurance coverage. The various financing options include:

• Employer-sponsored insurance. Instead of getting a stand-alone dental plan for your child, check if your employer offers medical insurance benefits and if the health plan includes dental care coverage for your kids.
• Government-sponsored medical programs such as Medicaid and CHIP. They are generally more affordable than private insurance plans.
• Flexible spending account (FSA). An FSA is a type of savings plan offered by employers that enables you to put aside part of your income pre-tax for your dental expenses. Your contributions cannot be rolled over the next year.
• Health savings account (HSA). Like an FSA, an HSA is a tax-advantaged savings account for medical expenses. However, it is only available to individuals enrolled in a High Deductible Health plan (HDHP). You can roll over your contribution to the next year.
• Community health centers and dental schools. They provide access to a wide range of dental services for kids at a low cost or for free.

Annual Maximum Limits

Most dental insurance plans for kids stipulate annual maximum limits – a maximum amount that the plan covers. If your child requires regular dental treatment, e.g., if they are prone to infections and tooth decay, go for a plan with a higher annual maximum limit.

Claim Process

For most people, the claim process is an afterthought when determining the right dental plan for your kids. Yet, it can be quite frustrating if it is cumbersome.

Therefore, you want to go for a plan that has an easy and straightforward claim process. Contact insurance providers for prospective plans to find out about their claim process and whether payments are made in a timely manner.

Provider Network

Some plans stipulate a specific network of providers. If so, check if there are dentists and dental facilities near you on the network. Also, research your preferred providers to establish if they are credible and offer quality dental care.

Age Restrictions

Age restrictions for dental insurance for kids vary from plan to plan. For some, the age limit is capped at 18 or 19 years, while others cover kids and young adults up to the age of 26 years.

Some plans also impose an age restriction on certain services, e.g., orthodontic services. Therefore, review a prospective plan’s details to see if any age restrictions apply.

Conclusion

Dental insurance for kids is important not only for maintaining their dental health but also for their overall health. With so many plans available, choosing the right one can be daunting. However, it gets easier when you know what to look for and the criteria for comparing various plans.

Start by establishing your child’s dental care needs. Familiarize yourself with the different types of dental insurance plans, how they work, and their pros and cons.

Then compare various plans according to their scope of coverage, dental services, monthly premiums and additional costs, provider network, if there are age limits, annual maximum limits, coverage limits, and waiting times.

Identify plans that meet your coverage needs and budget. Contact the insurance provider for more details on the terms and conditions and clarification on any questions and concerns you might have.

Narrow down to your most suitable option and enroll during the open enrollment period. Review your plan periodically to ensure that it meets your needs.