Open Enrollment: How to Choose a Dental Plan

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Open enrollment season for choosing a dental plan runs annually from mid-November to mid-December for coverage effective Jan. 1. That means you need to plan ahead for what you want and need in the new year.

Choosing the Right Dental Plan

Plans can change year-over-year, with costs fluctuating as well as the specifics around what any given plan offers. That means no matter what it's a good idea to review your plan every year and see if its still the right fit.

Out-of-Pocket Costs for Different Plan Types

There are two primary types of dental plans. A Dental Health Maintenance Organization (DHMO) plan includes predictable, pre-determined fees designed for transparency. In a DHMO plan, there are specific co-payments listed for each covered service. If you know the dental procedures you need to have completed, you will know exactly how much you will pay for your dental care before you even go to the dentist.

A Preferred Provider Organization (PPO) plan covers procedures as a co-insurance percentage. With a PPO plan, your out-of-pocket costs may not be immediately evident. For example, a major service like a crown may be covered at 50%. To calculate your actual cost, you will need to determine how much your dentist will charge you for that procedure under the contracted arrangement with the dental plan.

Many dental carriers provide a comparison tool that will allow you to compare features and your cost for specific procedures.

Anticipated Dental Services for the Upcoming Year

It is helpful to understand your specific dental needs in order to make an informed decision. FEDVIP offers standard and high option plans. If you know you will need major dental work done, you might want to select a high option plan that may cover more of the cost for major restorative procedures. If you need only preventive dental care, a standard option plan may make more sense.

Look for limitations, such as annual maximums or orthodontic lifetime maximums, to ensure that you are not paying out-of-pocket after you've reached a plan's limit.

Also, check whether the plan has any waiting periods that may be a barrier to receiving immediate dental care.

Access to Care

Verify that your dentist is part of your dental plan. If you have long-term loyalty to your dentist, you will want to confirm that they are in the network.

If you're selecting a new dentist, review the plan's network to ensure their office is near your home or office. Most plans offer an online provider search. You may also want to confirm participation with the provider's office.

Rates

Last but not least, during open enrollment it's important to compare the monthly premium for each plan. Affordability is important. Oral health doesn't have to be expensive. Many insurance companies offer low-cost plans that entirely or mostly cover the costs for oral exams, cleanings, fillings and X-rays.

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