As anyone who has dental insurance can tell you, finding the proper coverage can be extremely difficult as dental policies vary quite a bit. The biggest issue is that, most people who need to undergo a major dental procedure will run into a wall with their insurance being capped with a maximum payout falling extremely short of the actual cost of the procedure, which leaves them to fill in that gap with their own money, which can be quite a bit at times. This, in turn, can create a rather difficult and expensive dilemma, however, if your insurance covers „out of network“ dental care, you can get a lot more for your money by going abroad to get dental care.
Problems with Dental Insurance
In most cases, dental insurance will only cover 100 percent of the cost for basic procedures only. In fact, there exist a sliding scale which is commonly known as 100-80-50, which means that routine procedures such as check-ups and teeth cleaning, your insurance will cover 100 percent of the cost, basic treatments like fillings are covered up to 80 percent of the cost and major treatments, such as crowns and bridges, will only be covered up to 50 percent of their cost. This means that, if you need to get a crown or two or some other major procedure done, there is quite a bit left on the scale for you to cover on your own.
Dental coverage is, as mentioned before, capped out. Usually this ceiling is at around $1500 in the United States. The limitations of this cap are painful and obvious if you consider the average cost of a procedure like a root canal that requires a crown sitting at around $2200, leaving you with $700 which you have to cover. Furthermore, if you need more than one dental procedure within a year, chances are you’ll be paying for that on your own. The situation is similar in some other countries like the United Kingdom and Australia, where dental care services are covered by a mix of private payments as well as public health services.
In most cases, the insurance will not be covering restorative or cosmetic dental care. Even though the majority of us will understand that some procedures, like teeth whitening, are not absolutely needed and as such aren’t covered by our insurance, do keep in mind that some expensive cosmetic procedures such as dental implants or even orthodontic procedures aren’t covered by the insurance either, despite having a potentially higher need.
Further more, in most cases the insurance won’t cover conditions that existed beforehand. For instance, in the United States, despite the reforms introduced by Obamacare which have banned discrimination based on a person’s health status, which means that people can’t be denied coverage or charged more if they have a pre-existing condition, that still doesn’t include dental insurance.
How Do I Know Whether My Dental Insurance Covers Out-of-Network Care?
There is no easy answer to this question and it is probably best that you check with your insurance provider in order to be sure. In case you need it, here is a basic list of three types of dental insurance plans:
The Health Maintenance Organization (HMO). These are usually the cheapest plans when it comes to monthly premiums, but they also tend to restrict patients’ coverage and limit them to seeing dental care professionals within a specified network only.
The Preferred Provider Network (PPO). Compared to the previous type of dental insutance, these are usually more expensive and they allow patients to see dentists outside the preferred network, but at the same time they charge more for that service.
Indemnity Plans. Again, compared to the last two plan types, the costs are yet again higher for this type. In some cases the costs are so high they can be prohibiting to most people. The plus side is that they allow patients to see any dental care professional that they choose, regardless of their network.
Why Should I Consider Dental Care Abroad?
You get better choices and you get more value for your money. With the constant development of technology and the ever rising standards of care all around the world, high quality dental work is not something that is exclusive to Western countries. Just ask anyone who has went through a procedure in countries like Hungary, Poland, Thailand, Costa Rica, Vietnam or Mexico and you will find out that the majority of the people are extremely satisfied. Furthermore, while these countries maintain high standards of dental care, treatment costs are very low because the overhead expenses such as rent, staff wages and utilities are far, far below the costs in Western countries. As such, dental patients who travel to these countries can expect to save huge chunks of money they would otherwise have to spend back home. Overall, the savings can be as high as 70 percent. That same root canal procedure that needed a crown in the United States and would cost you around $2200? You will pay around $500 for it in Mexico, which is well within the maximum coverage limit of most insurance providers.
Simply by doing a bit of research you can have an extremely rewarding dental care experience in a foreign country while spending a fraction of the money you would spend back home. Around half a million Americans cross the borders every year seeking dental care. In fact, in some cases, the standards of dental care in Mexico are so high that some health insurance companies in the United States now include Mexican dental clinics in their networks. As such, make sure you check with your insurance provider and see if they are covering dental care trips across the border.