What major dental care is covered by the plan? What percentage of these costs will you be required to pay?

Since dental benefits encourage you to get preventive care, which often eliminates the need for major dental work, most plans are not generous when it comes to paying for major dental work, most plans cover less than 50 percent of the cost of major treatment.

Most plans limit the benefits--both in number of procedures and dollar amount--that are covered in a given year. Be aware of these restrictions when choosing your plan and as you and your dentist develop treatment best suited for you. Major dental care includes:

• Restorative care--gold restorations and individual crowns

• Oral Surgery--removal of impacted teeth and complex oral surgery procedures.

• Periodontics--treatment of complicated periodontal disease requiring surgery involving bones, underlying tissues or bone grafts.

• Orthodontics--treatment including retainers, braces and/or diagnostic materials.

• Dental Implants--either surgical placement or restoration

• Prosthodontics--fixed bridges, partial dentures and removable or fixed dentures.

Will the plan allow referrals to specialists? Will my dentist and I be able to choose the specialist? Some plans limit referrals to specialists. Your dentist may be required to refer you to a limited selection of specialists who have contracted with the plan's third party. You also may be required to get permission from the plan administrator before being referred to a specialist. If you choose a plan with these limitations, make sure qualified specialists are available in your area. Look for a plan with a broad selection of different types of specialists.

Dental Insurance for Children, Teens, and Students in California

If you have children, you may prefer a plan that allows a pediatric dentist to be your child's primary care dentist. Since specialized treatment is generally more costly than routine care, some plans discourage the use of specialists. While many general practitioners are qualified to perform some specialized services, complex procedures often require the skills of a dentist with special training. Discuss the options with your dentist before deciding who is best qualified to deliver treatment.

Can you see the dentist when you need to, and schedule appointment times convenient for you? Dentists participating in closed panel or capitation plans may have select hours to see plan patients. They may schedule appointments for these patients on given days, or at specified hours of the day, restricting your access.

Some California dental office fees for seeing you on weekends or during emergencies are high than those the plan allows. You may be required to pay additional costs yourself. If you select these types of plans, have a clear understanding of your dentist's policies as well as the plan's dentist-to-patient ratio. It's the best way to ensure your access to care is not unduly restricted and that you are not surprised by higher fees the plan does not cover.

Insurance companies do their best to ensure that their policyholders understand their plans and benefits, but it is up to an individual to make sure that they are making informed choices. The differences in the various plans you can choose from are:

• The type of third party funding the plan.

• Methods of selecting a dentist.

• Compensation of the dentist's services to you.

• The calculations of benefits and payments.

Understanding these differences will enable you to make an informed decision when selecting a dental plan that is best for you or your family.