An Expert’s Guide to Choosing Dental Insurance for Children

By Rebecca Hetzer

We’re right in the heart of open enrollment season for insurance, including dental insurance for children. If you’re like most parents, by the time you evaluate all your options, the leaves have fallen off the trees and Christmas bells are ringing. Insurance can be confusing, and trying to decide now what your family’s needs will be next year is both stressful and time-consuming.

In my role with The Dental Care Plus Group, I’ve counseled numerous families and groups on making sure they have the right dental insurance plans for their needs. Since I’ve seen firsthand how much confusion there is in the marketplace about dental insurance choices (especially for dental insurance for children), I wanted to provide a few tips that hopefully will help guide your decision making process during this open enrollment season.

Dental insurance for children: 4 tips for picking your plan

Tip 1: Your children may already be covered by your medical plan.

If you receive health insurance through a small employer (50 employees or less) or purchase it individually outside of state or federal exchanges, then your children may have dental benefits through your medical plan. This is a requirement of the Affordable Care Act (ACA), so you’ll want to check what’s covered before you purchase additional dental coverage for your children.

Tip 2: Not all plans are created equal.

Even if your children are covered by a medical plan because of the ACA, it’s very important to know that not all plans are created equal, and there can be a huge difference between a medical plan and a dental plan. As this infographic from the National Association of Dental Plans (NADP) illustrates, depending on your child’s needs and type of coverage you have, your out-of-pocket costs could range anywhere from $0 to about $3,000. That’s a huge discrepancy.

So how do you make sure you’re closer to the $0 instead of the $3,000?

Tip 3: Estimate your child’s dental needs for the year.

As you can see in the infographic linked above, the dental needs of your children have a great impact on your out-of-pocket costs. If you child has good dental health and just needs the standard cleanings and yearly x-ray, you’ll probably want to opt for a medical plan where preventive services are covered in full.

If your child needs extensive orthodontia work, then it’s probably worth paying a little extra for a dental plan, where the maximum out-of-pocket limit is going to be significantly lower.

Tip 4: Check to make sure your dentist is in network.

This may seem obvious, but you’ll want to make sure your preferred dentist is in-network. Using a network dentist can save you money because of the discounts the insurance company has negotiated. However, many families have established a great relationship with their dentist and are shocked when their dentist isn’t considered “in network.” Do your homework up front to avoid any confusion down the road.

Insurance can be confusing and overwhelming, but it doesn’t have to be. If you go into the open enrollment season knowing what to look for, you should be well-prepared to make the right decisions for your children’s dental health.

Rebecca Hetzer is the Executive Director of Sales, Established Business and Marketing for The Dental Care Plus Group, a dental insurance benefits provider. In her 12 years with DCPG, Rebecca has counseled countless individuals and groups on their dental benefits and wants to make sure everyone is making the right decision for their personal and financial health. She is also a working mom with three children.