Did you know that seniors need far more oral care than any other age group? Teeth, like any other body part, grow and decay as time goes on. People without dental insurance are less likely to take proper care of their teeth. It’s important to safeguard yourself against any future problems.

For Baby Boomers who are retiring and will lose employer sponsored insurance, they now will need to pay out-of-pocket for dental care or obtain alternative coverage such as through an individual dental insurance or Medicare Advantage plan. According to a recent study prepared for the American Dental Association, two-thirds (66 percent) of adults 65 and over have no dental coverage.

Spirit Dental has no age limits and provide baby boomers with dental plans that are not only affordable, but easy to understand and easy to use. Seniors need dental plans that deal with major services such as crowns, root canals, implants, dentures, and bridges.

It’s Spirit Dental’s mission to offer the perfect plan for everyone looking for dental insurance, no matter what their needs are.  You can choose your own dentist, there are no waiting periods, you have guaranteed acceptance, and all implants and major services are covered.

Did you know that seniors need far more oral care than any other age group? Teeth, like any other body part, grow and decay as time goes on. People without dental insurance are less likely to take proper care of their teeth. It’s important to safeguard yourself against any future problems.

For Baby Boomers who are retiring and will lose employer sponsored insurance, they now will need to pay out-of-pocket for dental care or obtain alternative coverage such as through an individual dental insurance or Medicare Advantage plan. According to a recent study prepared for the American Dental Association, two-thirds (66 percent) of adults 65 and over have no dental coverage.

Spirit Dental has no age limits and provide baby boomers with dental plans that are not only affordable, but easy to understand and easy to use. Seniors need dental plans that deal with major services such as crowns, root canals, implants, dentures, and bridges.

It’s Spirit Dental’s mission to offer the perfect plan for everyone looking for dental insurance, no matter what their needs are.  You can choose your own dentist, there are no waiting periods, you have guaranteed acceptance, and all implants and major services are covered.

By providing a wide range of affordable plans and benefits, Spirit Dental believes we can help you keep your oral health on track. Young or old, we will provide quality service and affordable plans. Thanks to our dental insurance, large expenses won’t stand between you and good oral health.  Coverage is just a click away.

“What is a waiting period and why do I have one on my dental insurance?

“Why isn’t all dental insurance offered with a no waiting period?”

“Why am I still waiting for my insurance to cover my dental procedures?” 

Are these questions you are wondering and maybe even confused about? At Spirit Dental, we keep things simple with no surprises. Once you’ve enrolled in a plan, you’re covered by insurance and can make that appointment with your dentist. We have no waiting period.  What does this mean and how does this help you? 

At Spirit Dental there are no waiting periods for preventive, basic or major services on the Spirit Dental plans. This means that on almost every one of our plans offered you will not be waiting for coverage, as soon as you are effective you are covered. Effective dates are the 1st, 5th, 10th, 15th, 20th and 25th of every month, so you’re maximum wait time is 5 days.

Many dental insurance carriers impose a waiting period on plan coverage. This means that after you’ve enrolled in an insurance plan, you have to wait up to twelve to eighteen months before having any of your major services dental needs are covered. You could still be paying your monthly premiums without the benefit of having your dental costs covered, leaving you to pay 100% out of pocket. The impact on your coverage is clear, a waiting period may leave you without coverage – and when you need it most.

At Spirit Dental, we will help you get coverage, answer all questions, and make sure you aren’t waiting to have any necessary dental procedures completed. This means as soon as your policy is effective you can immediately start making those vital and important dental appointments needed to start bettering yourself and your health! Get your 30 second quote today.

You’ve met Tom Mayer, Spirit Dental’s energetic founder and self-described “Rainmaker.”  But according to Mayer, it’s his parents – and the company’s twenty-person team – that have truly shaped the company’s success.   “When I was forming the company, I kept coming across the word, ‘Spirit,” a bunch of times in my daily life,” says Mayer.  “It just felt like the right name for the plan because that’s what I wanted for the company.  I wanted it to reflect the values and lessons I got from my family.  And I wanted to assemble a team that was as energized by the company mission as I was.”

Mayer says his diabetic father’s difficulties with dental insurance serve as a guide for continuously improving the Spirit Dental plan.  But it’s his mother’s sense of playfulness and creativity that can be felt – and, literally, seen – throughout the hallways of the company’s headquarters in St. Paul, Minnesota.   “Tom’s mother likes to paint,” explains Lisa Talcott, Sales Operations Manager for Spirit Dental’s parent company, Direct Benefits, pointing to the seemingly endless rows of hanging artwork.  In fact, a brief tour of the company quickly reveals that Mayer’s mother really, really likes to paint.  Her works, mostly oil on canvas, are everywhere.  (There is even a “nudes gallery” tucked away in a remote, less trafficked corner of the building.)  “Tom gets them all professionally framed and we display them here, as part of our permanent collection” says Talcott, smiling. “But since we’re always getting more, we’ve started a give-away.  Every visitor gets to choose a painting to take with them.”

Diane Lysen, Group Sales Executive for Direct Benefits, says the revolving art display and the giveaways are just a small part of the “very special” culture of the Spirit Dental team.  “It is just an absolute joy to come to work every day because here, I have made lifelong friends.  We just have so much fun here.”

Mayer agrees.  “Direct Benefits is a unique place because we’re all very emotionally invested in achieving our shared goal. If I were the only one here trying to create a revolution in the dental insurance industry, it would be awful.  But everybody here is trying to start that revolution!”  While everyone shares the goal, each team member is strongly encouraged to bring their individuality – and a sense of humor – to work each day. 

“We each have our own alter ego,” says Talcott.  “If we feel like coming to a meeting as our alter egos, we do,” she explains.  “We even have costumes. ”  There is a Fairy Godmother, a Dental Guru, a caped Benefits Superhero, a Ninja, a Commando, a Princess, a Fairy, a Therapist, a Rock Star, a Genie, a Coach, and an Ace in the Hole.   Mayer, of course, is “the Rainmaker.”

For Mayer, it’s all part of creating the right work environment by celebrating the power that each individual brings to the business.   “I really enjoy the culture we’ve all established here now,” adds Mayer, who says growing the company too much more would risk losing that magic.   “There are twenty of us here now and that really works.  Everyone knows each other’s stories.  We know we can count on each other.  Turning this into a huge company would mean taking that away.  I can tell you right now, if I had 200 employees, that would be the worst nightmare in the world!”

Mayer obviously relishes the fact that everyone is passionate about proving Spirit Dental is the best dental insurance in the world.   “We know how intimidating and confusing it can be to compare dental insurance.  So we’ve made a point of setting ourselves apart from everyone else.”   If you don’t believe him, Mayer says all you need to do is stand in one of Direct Benefits’ painting-covered hallways and listen.  “When our phones ring, we answer them.  We actually talk to the people calling us, because we remember that’s someone’s mom or sibling or grandparent on the phone, trying to find better dental insurance than they got someplace else.” 

“The people here make Spirit Dental so different from the traditional insurance company,” says Mayer.  “And we’re really proud of that.” 

To learn more about Spirit Dental and Tom Mayer, please visit us at www.spiritdental.com.  Click here to get your Spirit Dental 30 Second Quote.

Whether you’re searching for dental insurance for yourself, your children, or your aging parent, you’ve probably already made at least one unfortunate discovery:  shopping for plans can be confusing, overwhelming and downright frustrating.  Worse, unless you started your search here, at Spirit Dental, you probably got the impression (from our larger competitors) that dental insurance is expensive, never provides more than $1,000 or $1,500 per year in coverage, has required waiting periods, provides extremely limited coverage, and excludes some procedures altogether.  It’s hard to justify the costs of premiums when the major procedure you need is excluded – or exceeds your annual max.

“It’s as if the large insurance companies think you don’t know how to do basic math,” says Tom Mayer, founder and CEO of Spirit Dental.  “At Spirit Dental, we know our customers can do math.  They’ve got their own calculators.  They know how the dollars add up.”

Mayer, the outspoken critic of traditional dental insurance plans, says Spirit Dental’s products were designed to meet the needs of the 21st century consumer.  The key, he says, was creating a level of flexibility between plans to allow anyone to find a plan that’s best for them.  There are key differences between the Spirit Dental plans.  Some offer a $3,500 annual maximum while others have lower premiums with lower annual maximums.  But no matter which product you choose, Mayer says, Spirit Dental promises a superior insurance product to protect your oral health, your overall physical health, and your finances.   Key features of all Spirit Plans include:

• 3 Cleanings per year – Driven by the belief that excellent physical health is closely linked to healthy teeth and gums, all Spirit Dental plans cover 3 cleanings per year.
• Implant coverage is available with no waiting – Many traditional dental insurance carriers refuse to cover implants by categorizing them as “cosmetic.” Still others claim to cover them – but then impose waiting periods of up to five years. Ask a licensed insurance agent about limitations and exclusions for any plans that you consider.
• No waiting periods for anything – Your coverage begins immediately upon effective date and with 6 enrollment periods per month, you never have more than 5 days to wait before your enrollment is complete.
• $1,200, $2,500 or $3,500 annual maximums – Choose a plan that best fits your budget based on your estimated annual dental expenses.
• $100 Lifetime Deductible – Some insurance companies make you meet an annual deductible before they start paying for your dental expenses.  At Spirit Dental, you can pay a one time, lifetime $100 deductible. 
• Indemnity or PPO – It’s your choice!  If you have a dentist you love, enter their name in our preferred provider search to see if they’re a member of our network.  If they are, great!  If they’re not, you can keep them and choose one of our indemnity plans.  Or, you can select a dentist from our network of preferred providers and enroll in one of our PPO (Preferred Provider Organization) plans.
• Guaranteed Acceptance – You simply select the plan that’s right for you.  No proof of health.  No exclusions.

See for yourself how much better dental insurance can be! 

Tom Mayer invites you to compare Spirit Dental to anyone else in the industry by taking our 30 Second Challenge. “I guarantee you,” says Mayer, “you’ll see the differences.”  After reviewing the results, simply choose the next step that’s best for you.  “We believe we have a products will fit any customer’s needs and I would love to see everyone sign up with Spirit Dental.  But my goal is to see dental insurance improved for everyone in America.  So I would be just as happy if people went back to their giant insurance companies and asked them why they won’t provide $3,500 annual maximums, no waiting periods, and coverage of major procedures,” says Mayer.

To learn more about Spirit Dental and Tom Mayer, please visit us at www.spiritdental.com.  Click here to get your Spirit Dental 30 Second Quote.

Ask Tom Mayer for his actual job title and you’re likely to hear one of several monikers.  “I prefer Rainmaker,” is one of his favorite answers.  He prefers it so much, in fact, that he’s been using it on his business cards and website.  “Saying CEO or Founder is so boring,” claims Mayer.  “What do words like that tell you about someone’s responsibilities within their company?”

Rainmaker seems a fitting description for the man at the helm of Spirit Dental and its parent company, Direct Benefits. His track record for business savvy and chutzpah dates back to his childhood. (A “kid-for-rent” lawn service, started by Mayer at age 11, proved to be the springboard for a succession of highly profitable enterprises that Mayer has successfully launched, grown and sold over the years.)  Indeed, Mayer’s story reads more like a classic tale of a self-made, American entrepreneur than a resume.   The son of an elementary school janitor and a very artistic mother, Mayer credits his father for his work ethic and his mother for the ingenuity that has driven Spirit Dental’s innovative product design.   “But it was really my dad’s experience with inadequate dental insurance – and the financial hardship that created for our family – that drove me to start Spirit Dental,” says Mayer.  As a school employee, Mayer’s father had one of the best plans in the industry.   But his diabetes caused lifelong dental issues.  Often, his yearly $1,000 maximum was gone by February.   “That’s when I was a kid,” says Mayer.  “You know the worst part of that story?  The worst part is that a $1,000 maximum was still considered the gold standard until about 2001.” 

That’s when Mayer founded Spirit Dental.

According to Mayer, the dental insurance industry has been dominated by a handful of behemoth providers for decades.  As a result, he says, the American public has come to believe that all dental insurance is expensive, difficult to acquire, and rarely sufficient to cover major procedures.   “We rejected that thinking,” says Mayer.  “And we began designing our products from the consumer’s point of view.” 

Today, Spirit Dental offers a range of products to families and individuals, including retirees, that Mayer says are superior to anything else on the market.  But, he is quick to add, creating better products was the easy part.  Changing Americans’ beliefs about dental insurance has proven to be the challenge.

“When people start looking for dental insurance, they look at the same old companies that have been doing this for decades,” says Mayer.  “And they see pricing and coverage limits that make them think they can’t afford to protect their oral health.”  As a result, says Mayer, people have begun seeing dental insurance as a luxury.  It’s a view that Mayer sees as potentially life threatening. “Studies have shown correlations between gum disease and heart disease, diabetes, and other serious illnesses,” says Mayer.  “Just a simple, routine dental check up can uncover up to 120 illnesses early enough for them to be treatable.  But every year, increasing numbers of people choose to skip their visits to the dentist because of the cost.  That’s pretty scary when you realize that 75% of American adults have some form of periodontal disease and don't even know it.”  Perhaps even scarier is the fact that more than one fifth of all American adults and 15.6% of American children (ages 6-19) have untreated cavities, placing them at risk for potentially fatal infections.

Those are the reasons that Spirit Dental exists, says Mayer. “We’ve set big goals for this company, but making a whole lot more money isn’t one of them,” he says.  “Our goal is to start a revolution within the dental insurance industry.”  With that, Mayer reiterates his open invitation to American consumers, whether they currently have dental insurance or not:  “Take 30 seconds out of your day.  Get dental insurance quotes from Spirit Dental, along with our (much larger) competitors. I guarantee you, you’ll see the differences.”  After that, says Mayer, consumers can choose their next step.  “We would love to see everyone sign up with Spirit Dental.  But we would be just as happy if they went back to their giant insurance companies and asked them why they won’t provide $3,500 annual maximums, no waiting periods, and coverage of major procedures,” says Mayer.

Mayer, a self-described “very private person,” says calling himself the Rainmaker means being willing to go to whatever lengths necessary to achieve the company’s goals.  “So, if I have to dress up like the Tooth Fairy and ride around town, on my motorcycle, inviting people to take the 30 second challenge, that’s what I’ll do.”

To learn more about Spirit Dental and Tom Mayer, please visit us at www.spiritdental.com.  Click here to get your Spirit Dental 30 Second Quote.
(To see Tom Mayer as the Tooth Fairy, click here.)

The Truth About Senior Dental Insurance
If you are one of the many working Americans who believe their employer’s retirement benefits include dental insurance, you may be in for a rude awakening:  growing numbers of American employers are dropping their retiree dental benefits. And if you were thinking that Medicare would provide any kind of dental safety net, there is worse news: in most cases, Medicare does not.

Each year, more American retirees are surprised to learn that, if they want dental coverage, they will need to purchase it themselves, as stand alone dental insurance. Many simply choose to go without. Today, roughly 75% of people age 65 and over have no dental coverage whatsoever. Their reasoning may be understandable. In a recent AARP study, 53% of Americans age 50 plus, said they worry they will encounter health expenses after retirement that they won’t be able to afford. Yet, while budgeting for health care coverage, they seem to view their dental health as a luxury. While it may be tempting to view dental insurance as a non-essential, it is inaccurate. And it is dangerous.

The Dental-Medical Connection
According to the Mayo Clinic and the Centers for Disease Control (CDC), regular dental check-ups – and the prompt treatment of any dental issues that they uncover – are keys to warding off serious illness. Indeed, countless studies show the link between gum disease and medical conditions such as diabetes, heart disease and stroke. But consider this: 75% of American adults are unaware that they have periodontal disease, increasing their risks of complications associated with these other diseases. And nearly 20% of people age 65 and over have untreated dental cavities, putting them at risk for potentially fatal infections. 

The great news is that a routine dental exam can result in the early detection of more than 120 diseases.  The bad news for American seniors: fewer than 2/3 of them went to the dentist in 2012. 

The simple truth is, regular, rigorous dental care is not a luxury.  It is a necessity (if your goal is to enjoy great physical health as you age). But it has become an increasingly unattainable one. Dental care costs have increased steadily over the past several years, while most dental plans available today – even if they are employer supported – provide such meager coverage that trips to the dentist have become a significant financial burden. In his recent Huffington Post article, journalist and health care reform advocate, Wendell Potter pointed to the fact that typical plans include 50% copays for procedures such as crowns and bridges, have “missing tooth” clauses, and top out with $1,500 annual maximums that fall far short of the annual dental costs that many of us face.  With out-of-pocket expenses like these, Potter worries that many of us are delaying those trips to the dentist, and putting our overall physical health at risk.

An Open Invitation from Spirit Dental
Tom Mayer, Spirit Dental’s founder and CEO, agrees.  He says he designed Spirit Dental's insurance products to address the concerns that retirees face today, “because I wanted to create dramatically improved, affordable dental insurance for people like my dad.” Mayer’s father, a school janitor, was a diabetic who suffered the many dental complications associated with diabetes. “By January of each year, he would have his annual deductible spent.  The rest of the year, he paid for everything himself.”

Mayer says his goal is to improve the level of dental coverage in this country.  And he’d like to start that dialogue with this open invitation: “Take 30 seconds out of your day. Get dental insurance quotes from Spirit Dental, along with our (much larger) competitors. You will see the differences.”

After that, says Mayer, consumers can choose their next step: “sign up with Spirit Dental or go back to the giant insurance companies and ask them why they won’t offer you $3,500 annual maximums, no waiting periods, and coverage of major procedures,” says Mayer. Either outcome would be a success to him. “I’m not trying to grow Spirit Dental a lot bigger,” says Mayer. “I’m trying to change the national conversation about dental insurance.”

To learn more about Spirit Dental and Tom Mayer, please visit us at www.spiritdental.com.  Click here to get your Spirit Dental 30 Second Quote.

Americans shopping for dental insurance often face conflicting reports and mixed messages about the various options available to them. At Spirit Dental, we believe that shoppers should be presented with all the facts to make informed decisions. So in upcoming stories/posts, we’ll explain some common misconceptions about dental insurance – and what you should look for to find the plan you need.  

Tom Mayer

Need for Dental Insurance
The National Association of Dental Plans reports that nearly 127 million Americans lack dental coverage -- more than a third of the U.S. population! But many people are coming to understand that preventive dental care – like other forms of preventive health care – not only helps them stay healthy, but also is more cost-effective. In fact, the American Dental Association reports that for every dollar spent on preventive dental care, Americans save $7 dollars later on.

However, shopping for dental insurance is not a walk in the park. Because so many Americans are unfamiliar with dental coverage options, many fail to understand what they’re getting when they sign on with a plan. The bottom line is that dental coverage plans often highlight the positive plan features and bury the problems in the fine print.

Discount Dental Plans vs. Fully Insured Plans
Discount dental plans, sometimes called dental price clubs, have been around since the early 1990s. They provide members with discounts on fillings, exams, routine cleanings, and other dental services.  Subscribers pay monthly or yearly membership fees and participating providers accept a pre-negotiated fee as payment for services, usually at the time of service. Discount plans are not insurance. Spirit Dental is insurance.

Annual Maximums for the 21st Century
Spirit Dental pays up to $3,500 of dental expenses per person each year, twice as much as many dental insurance plans.  Says Spirit Dental CEO Tom Mayer: “The 20th century dental insurance plan is dead!  The old days of your dental insurance plan only paying $1,000 a year are over.” With Spirit Dental plans, dental bridges, implants or root canals, which can cost thousands of dollars, are covered.  And don’t forget – no waiting!

Waiting Periods
Many dental insurance plans have waiting periods on major services, like crowns, bridges, dentures and implants. Some discount plans still subject members to a waiting period before their discount is applied. Spirit Dental has NO waiting periods on major services.

Provider Network Options
Many discount plans require the member to use a participating provider in a limited network. Spirit Dental insurance plans allow the freedom of choice to use a network provider or go to the dentist of your choice.

Spirit Dental or Discount Plan? You Be the Judge
If you want to choose your own dentist, schedule an immediate appointment, and receive expanded annual coverage, the choice is clear: Spirit Dental beats other dental insurance and discount plans.

• Choose Your Own Dentist
• No Waiting Periods for All Services
• $1,200, $2,500 or $3,500 Annual Maximums
• 3 Cleanings Covered Per Year

Back to school season has always been a good time for Jane to get organized. After shopping for clothes, school supplies, immunizations and medical check-ups, she finally made time to shop online for dental insurance. She was confident that she’d covered all the bases without breaking the bank –x until her son broke a tooth in football practice. Then, the truth came out – there was a waiting period on her new dental policy and the trip to the dentist wasn’t covered.

The waiting period also surprised Dick, who had purchased an online dental plan a few months before he bit into some hard candy and broke an old filling. Ouch! It hurt even more having to pay full price at the dentist after paying the monthly premium.

Only Sally is smiling today. She compared a number of dental insurance plans and chose Spirit Dental. Affordable, broad coverage and best of all – no waiting!

We all know the importance of staying healthy, from head to toe, and this often comes with a price. Especially when we take preventative measures, like ensuring we have vision & dental insurance. Unfortunately, if you have to pay the full cost of dental care, you may have a hard time paying your dentist bills. Perhaps even more seriously, without dental coverage you may be tempted to skip regular cleanings and checkups, a decision that could lead to serious dental health problems.
One of the nuisances of insurance is having to pay the deductible. Most dental plans have a specific dollar deductible that you must pay annually. Therefore, during a benefit period, you have to satisfy a portion of your dental bill before your benefit plan will contribute to your cost of dental treatment.

Do you ever wish you could skip this annual deductible?  Well now you can!  Spirit Dental & Vision plans offer a $100 lifetime deductible.  In other words, there are no annual deductibles.  You pay $100 once and never again.  Visit https://www.spiritdental.com/ for more details.

The Dental Implant Downside
Unfortunately, replacing missing teeth with dental implants isn't always an option. Why?

• A basic dental implant typically costs $1,250 to $3,000 -- or as much as $60,000 for a full set of implants on both upper and lower jaws. Clearly, dental implants are a major investment. 

• Because implants are classified as cosmetic dental procedures, they are often excluded by dental insurance. Other dental insurance plans offer some coverage but require waiting periods of up to five years before implant coverage begins. Other insurance plans exclude implant coverage if it’s linked to a pre-existing condition. 

All Spirit Dental Plans Cover Tooth Implants
With Spirit Dental, you don’t have to worry about exclusions buried in the fine print. Our policy is clear: Every Spirit Dental plan covers tooth implants. With Spirit Dental you also have more flexibility, more preventive care and more annual coverage. 

Do you rely on a Medicare Advantage plan for individual dental insurance and visual insurance? If you do, your coverage may end later this year due to Affordable Health Care Act budget cuts. What should you do?

Finding affordable dental care can be challenging—but you have options. If you need a new dentist, it’s good to know that most dentists are doing everything they can to make their services more affordable. Today, most dentists offer or accept savings plans, and many provide new-patient specials that give you free first visits and treatment discounts. In-house or third-party financing -- with reasonable payment plans – are often available. If you’d prefer individual dental insurance to fill your coverage gap, you’ll find the plan and the coverage you need at Spirit Dental.

Look to Spirit Dental for Affordable, Same-Day Coverage

With Spirit Dental, you’ll find a flexible, affordable plan that fits your needs and your budget. Click us for 30 second online quote today and compare our rates and our benefits with other plans. You’ll see why Spirit Dental offers the best dental insurance plans in America. With a Spirit Dental plan:

• Choose Your Own Dentist
• No Waiting Periods
• Guaranteed Acceptance
• Implants and Major Services Covered
• Three Cleanings Per Year
• Choose From $1,200, $2,500, or $3,500 Maximums

More questions? A Spirit Dental has the answers you need:

• Are there any waiting periods?

Never. At Spirit Dental, when you sign up, you’re in. The power of no waiting can be yours!

• My dentist has never heard of Spirit Dental. Do they have the resources I need?

Spirit Dental is backed by the top insurance carriers in the industry -- Security Life and Spirit PPO. Don’t worry. When you need us, we’ll be there for you.

• What is an annual maximum?

With most dental insurance, coverage for your dental care ends when you reach the annual maximum payment – usually about $1,500. Spirit Dental offers a range of plans to suit your needs, including plans with an annual maximum of $3,500.

How Can I Save Money on My Kid’s Braces?

Many parents run into serious issues when their kid’s permanent teeth come in. According to Betterhealth, your central incisors or your “two front teeth” begin to arrive at just 6 to 7 years old and your last “adult” teeth or molars come in on average at 13. Most parents are hopeful that their children will never need braces. Some may think, “Since I didn’t need them my children won’t either”. Yet most orthodontists would disagree and estimate that “roughly 45 percent of children need braces to fix functional problems such as a misaligned bite, but up to 75 percent of kids could benefit from them to straighten their teeth” (Health.com). Without dental insurance, the overall cost of braces can be expensive. The cost of hardware and orthodontist treatments will range from $4,000 to $8,000 dollars. In the likely scenario that your child needs braces, what is the best way to save money?

The answer is dental insurance for children. Most insurance companies do not cover orthodontia, so it is important to find one that does. The main issue with orthodontic coverage is that it is not typically provided immediately upon enrollment. By getting your family insured earlier rather than later, you can save big.

An example of a plan that is great for orthodontic savings is the Spirit PPO plan. PPO means that you have a network of dentists who agree to lower their prices for services, making it cheaper for you and your family. Under this plan, aside from getting dental exams and cleanings for free, you will also get Basic, Major, and Ortho Services at least partially covered. Without coverage you might end up having to pay 100 percent out of pocket. Whether your child has to get braces for physical reasons or you want him or her to grow up with a wonderful confident smile, reconsider investing in a family dental PPO insurance plan.

-Written by Anthony Calderon

This is a simple phrase that explains the role of insurance in modern life.  Whether it is insurance that is mandatory, like auto insurance, or elective like dental it is important to understand why insurance is worthwhile, and how it works.

Let’s take auto insurance as an example of how insurance works.  Drivers have the same general risk, getting into a car accident.  The risks vary from a few hundred dollars for a “fender-bender” to millions due to injury.  While only a few of us will encounter the worst, we all want to be protected from that risk.

The insurance company determines that for every X number of people who pays insurance, one person will need to have coverage for the worst.  The money needed to pay for that person’s catastrophic accident, and smaller claims, is the largest part of your insurance premiums.  The rest of your premium goes to overhead costs, and keeps the insurance pool large enough to pay any claims.  For insurance to exist, more people must pay more than they will ever get back from a claim.  Considering what would need to happen for us to get our money back, most of us would consider that a lousy lottery to win.

Thankfully when it comes to dental insurance the same concepts apply, but the risks are considerably smaller.  Dental insurance plans also pay out less than what most people put in.  Only if you have serious dental work to be done can you expect to “get your money’s worth,” or get ahead at the end of the year.  But dental insurance does help spread the cost out over a year, and many plans save you money if you go to a network dentist (see also: PPO, HMO, DHMO).  With dental insurance most of us hope we never need to file that big claim, but it is important to know that if we need to it is there.

Is there such a thing as full coverage dental insurance?

This is a question we get quite often, and the short answer is no.  Dental insurance will not cover every procedure you will need at 100%.  Dental insurance is a tool to help protect you from extremely high dental bills, but even with the best coverage you will be paying something out of pocket.  Most dental insurance will cover preventive or routine work like cleanings and exams at 100%, but coverage for basic or major work will have some limitations.

The most comprehensive dental insurance on the market typically limits coverage for basic and major work in a couple ways.  First, most plans include a waiting period for basic and major services.  The waiting period is typically 12-18 months of coverage under the plan, although some procedures like fillings may only have a 6-9 month waiting period.  Spirit Dental has no waiting periods for Basic or Major Services.  Coverage starts as soon as your plan does!

The second way dental plans limit coverage is through the use of annual maximums.  An annual maximum is the maximum dollar amount an insurance plan will pay out for covered services per calendar year.  This is a real concern for those needing major work because many plans have a low limit, like $1000 or $1500.  If you happen to need a few thousand dollars of work, anything after that amount will not be covered.  Spirit Dental offers three different annual maximums, $1200, $2500 and $3500.

But the most important restriction most plans have is no coverage at all for some procedures.  Many dental plans on the market limit the number of procedures you can have in a period of time, like one crown every year.  Some dental plans will not cover crowns, implants, or orthodontia at all.  Details like this tend to be buried in the fine print, so it is important to look closely at what a plan covers before you decide to buy.  You don’t want to get a plan that does not cover implants or crowns when you know you may need one or both of them in the future.  We are happy to provide a Spirit Dental which does cover implants, crowns, and child orthodontia.

What is the "exchange"?

Healthcare reform is here, and a lot of people have important questions about how it affects them and what they may need to do to starting January 1, 2014. The simple answer for individuals is that if you currently have a medical plan (either with your employer or an individual policy), you do not need to do anything. For individuals who do not currently have medical insurance, the individual mandate will require you to purchase insurance for yourself (and dependents) or pay a tax (the insurance mandate only applies to medical insurance, not dental insurance. You are not required by law to have dental insurance). But the law is also intended to make buying medical insurance easier, and therefore we have the healthcare exchange.

The healthcare exchange is an online marketplace created to provide the public with individual healthcare plans. The plans on the exchange meet the new standards that healthcare reform requires. Each state is responsible for either creating their own state-run exchange OR being part federal government exchange. On the exchange, you will find medical insurance plans and dental insurance plans offered by private companies that are available in your state. In addition to being a one-stop shop for insurance, the exchange also provides subsidies to make buying medical insurance easier for those with low incomes.

State Exchange Websites (as of 10/15/13):

• California – Covered California: https://www.coveredca.com/
• Colorado – Connect For Health Colorado: http://connectforhealthco.com/
• Connecticut – Access Health CT: http://www.ct.gov/hix/site/default.asp
• District of Columbia – Health Benefit Exchange: http://hbx.dc.gov/
• Hawaii – Hawaii Health Connector: http://www.hawaiihealthconnector.com/
• Idaho – Your Health Idaho: http://www.yourhealthidaho.org/
• Kentucky – Kynect: https://kyenroll.ky.gov/
• Maryland – Maryland Health Connection: http://www.marylandhealthconnection.gov/
• Massachusetts – MA Health Connector: https://www.mahealthconnector.org/
• Minnesota – MNsure: http://www.mnsure.org/
• Nevada – Silver State Health Exchange: http://exchange.nv.gov/
• New Mexico – New Mexico Health Insurance Pool: http://www.nmmip.org/hrp1/
• New York – New York State of Health: http://www.healthbenefitexchange.ny.gov/
• Oregon – Cover Oregon: http://www.coveroregon.com/
• Rhode Island – Heath Source RI: http://www.healthsourceri.com/
• Vermont – Vermont Health Connect: https://healthconnect.vermont.gov/
• Washington – Washington Health Plan Finder: www.wahealthplanfinder.org/

Federal Health Exchange: https://www.healthcare.gov/

Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Louisiana, Maine, Michigan, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Jersey, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Dakota, South Carolina, Tennessee, Texas, Utah, West Virginia, Wisconsin, Wyoming

The world of insurance is complicated, sometimes needlessly so. One topic we discuss with clients on a daily basis is networks, or more simply “who accepts this plan?” It’s confusing, so let’s start by explaining what a network, HMO, PPO, and Indemnity plan is.

Network is the easiest of these to understand because it is a word used outside of the insurance industry. In insurance a network is a group of doctors that sign an agreement with that network. Doctors (providers) are then bound to the network, which typically requires them to charge members of that network a reduced rate for their services. In return for lowering their prices, network providers (doctors) can expect to receive more customers. Some dental insurance companies keep premiums down by only offering plans that use a network.

Larger networks typically have smaller discounts, while small networks can offer deeper discounts. This is the primary difference between a PPO (Preferred Provider Organization) and a HMO (Health Maintenance Organization). HMO’s generally have less options because less providers are part of the HMO, but the discounts are deeper. PPO’s generally have more providers in more areas, because more doctors agree to the network’s terms and discounts.

HMO’s tend to have less providers but it can also be the most affordable. This is because HMO’s control all aspects of the healthcare. The downside of HMO’s is choice, as you are strongly encouraged to go to a HMO provider.

PPO’s exist to offer clients as many options as possible while keeping premiums down. PPO’s use a network (or multiple networks, the Spirit PPO uses the Careington and DenteMax) that actively recruits doctors to provide care under the PPO. So PPO’s generally have more options than HMO’s, but there are, however many doctors who prefer not to be part of any network.

For clients who want more choice, an Indemnity plan allows them to see any dentist. The Spirit Indemnity plan will pay any dentist a set amount for each procedure. The payments are based on 90% of Reasonable and Customary in each area, meaning that 9 of 10 dentists charge that amount or less. So the Indemnity plan provides coverage with no networks to worry about. The Spirit Indemnity plan is perfect for people who want the freedom to see any dentist.

If you have any questions about this or topic or any others relating to Dental insurance, click to chat or give us a call (800) 620-5010. To see the options we provide in your area click here.

Add the optional Spirit EyeMed coverage to your dental insurance and you'll save if you wear glasses or contacts. Without coverage, an exam and prescription glasses can cost $300 or more. You have EyeMed access to thousands of private practice and retail-affiliated network providers located in convenient neigborhood locations across the country.

Spirit Vision Coverage Highlights

Spirit Dental & Vision’s vision plan is available through the EyeMed Vision Care Network. EyeMed is a leading vision benefits company, offering the following features:

• Savings on eye care and eyewear 
• Quality standards for care and materials 
• Access to thousands of providers nationwide, including the nation’s top optical retail brands 

Copays for Exams Lenses and Frames

• Eye Exam $10 Copay (Once every 12 months.)
• Eye Glasses/Lenses $20 Copay (Once every 24 months)
• Frames $0 Copay (Once every 24 months)

Contact Lenses

• Contact Lenses (Once every 24 months instead of lenses and frame)
• Contact lens wearers will pay up to $55 for standard contact lens exam, including fit and follow-up, or receive 10% off retail price for premium contact lens exam, fit and follow-up.
• Plans include a $100 retail allowance that can be applied toward the purchase of conventional or disposable contact lenses. 
• If the member chooses conventional contact lenses with a retail price over $100, he or she will receive 15% off the balance. Medically necessary contact lenses are paid in full after the copay. 
• Replacement contact lenses can be ordered online and conveniently delivered to members’ homes through www.eyemedcontacts.com. 

Additional Discounts

Spirit Vision members will also receive unlimited additional discounts on purchases made at participating provider locations, including:

• 40% off additional complete pairs of eyeglasses
• 15% off additional purchases of conventional contact lenses
• 20% off non-covered items like cleaning cloths or nonprescription sunglasses

Other Non-vision Insurance Discounts

Coatings and lens treatments can be added for the costs below:

The Spirit Indemnity Dental Insurance plan helps individuals and families cover the costs of dental care

Covered dental services include exams, cleanings, fillings and extractions, as well as crowns, root canals, bridges and dentures.

The policy pays for covered dental expenses based upon a percentage of the reasonable and customary (R&C) fees for those covered expenses after the deductible has been satisfied. 

The percentages are: 

• 100% for Preventive Services, 70% for Basic and 10% for Major Services in the 1st year.
• In the 2nd year of coverage, Basic Services increase to 80% and 50% for Major. 
• In the 3rd year, Basic Services increase to 90%

Highlights of the plan include: 

• The right to choose your own dentist.
• Calendar Year Maximums - $1,000, $2,000 or $3,000 per insured
• Two dental exams and three cleanings are included per calendar year
• One series of bitewing x-rays per year
• Space maintainers
• Sealants (children to age 16)
• One topical fluoride treatment per year to age 16

Major services include:

• Simple extractions
• Implants (endosteal only), up to the allowance for the lowest cost covered traditional procedure
• One diagnostic x-ray, full or panoramic in any 3 year period
• Oral surgery
• Endodontic treatment
• Periodontic services
• Restoration services; inlays, onlays and crowns
• Prosthetic services; bridges and dentures
• Basic fillings

The Spirit PPO Dental Insurance plan helps cover the costs of dental care. Covered dental services include exams, cleanings, fillings and extractions, as well as crowns, root canals, bridges, and dentures.

This policy pays you for covered dental expenses for Careington (Maximum Care) PPO Provider or Non PPO providers (Out-of-Network) based on the contracted fee amount negotiated with Careington (Maximum Care) organization after the deductible has been satisfied.

The percentages are:

• 100% for Preventive Services, 40% for Basic, 20% for Major and 10% for Ortho Services in the 1st year.
• In the 2nd year of coverage, Basic Services increase to 80%, 50% for Major and 25% for Ortho Services.
• In the 3rd year, Basic Services increase to 90%, Major Services increase to 60% and Ortho Services increase to 50%.

Highlights of the plan include:

• Spirit Dental allows you to select your own Careington (Maximum Care) dentist.
• Calendar Year Maximums - $1,200, $2,500 or $3,500 per insured
• Two dental exams and three cleanings are included per calendar year
• One series of bitewing x-rays per year
• Space maintainers
• Sealants (children to age 16)
• One topical fluoride treatment per year to age 16

Major services include:

• Simple extractions
• Implants (endosteal only), up to the allowance for the lowest cost covered traditional procedure
• One diagnostic x-ray, full or panoramic in any 3 year period
• Oral surgery
• Endodontic treatment
• Periodontic services
• Restoration services; inlays, onlays and crowns
• Prosthetic services; bridges and dentures
• Basic fillings

Children Orthodontia benefits include:

• Orthodontic care for the proper alignment of teeth is provided only to dependent children who are under 19 when treatment is received
• Coverage is 10% 1st year, 25% 2nd year and 50% 3rd year with a $1200 lifetime maximum per child

"Give Kids a Smile Day" was a big success in Upper Darby last week. Over 200 appointments were made to have children's teeth screened during the event held in Upper Darby, Delaware. This was the first year that the event was held in the upper Darby area. Eight dentists from Darby and nearby Philadelphia participated in the event.

The goal of the event is to administer immediate care then help children find a local dentist that they can see on a regular basis. The organizers want to identify children without Delaware dental insurance get them set up with dental care services year-round. "We looked into a lot of mouths and solved a lot of potential problems for children this week", said the organizers.

The Give Kids A Smile program began in 2003 under the sponsorship of the (ADA) American Dental Association. Dentists and other dental professionals donate their time and services to provide exams, treatments, and education. The program started out as a local one-day event but has expanded into both local and national events 365 days per year. Each year, approximately 450,000 children benefit from more than 1500 events, all because of the efforts of 40,000 or more annual volunteers.