With the rising cost of dental fees these days, many people are starting to wonder if purchasing a dental plan would be such a good idea or not. Either you're planning to purchase a dental insurance through your employer or independently, always investigate and compare different several different plans and ask about these guidelines we have listed below.
Yearly Maximum and Affordability
Every year your dental insurance plan pays for your dental services up to a certain pre-specified amount only. That ceiling amount is what you call the yearly maximum, which automatically renews every year, but if you have any unused benefits, those won't get carried over to the next year.
In/Out of Network Dentists
Most independent insurance plans have what is called an In-Network Dentist, to whose services only they require you to acquire in order for the company to pay for your dental fees. ON the other hand, if you like to stay with your current dentist, try to ask if the plan supports an option for you to choose your own Out of Network dentist, which mostly companies pay only a portion of the dental fees and you would have to pay the extra for the excess of the bill.
UCR (Usual Customary and Reasonable)
Companies always use a Usual, Customary and Reasonable (UCR) fee guide. This means that they set their own price that they agree to pay for every dental procedure they will cover, most of the time it is based on their own decision and not on what the dentist charges.
Oftentimes the company and the contracted dentist have an agreement to write off the differences between the dentist's regular prices, the reason why you shouldn't be charged extra for the excess. In case you prefer your own dentist, you may have to pay the difference out of your own, but always check the insurance company's UCR fee guide.
Dental Insurance Coverage Types
Most insurance companies break dental procedures into three categories:
1. Preventative
This includes routine cleaning and examinations, but sometimes X-rays, sealants and fluoride can also be considered as preventive or basic dental care depending on the specific insurance carrier.
2. Basic or Restorative
Fillings, root canals and simple extractions are grouped as basic or restorative dental treatment, but root canals are sometimes considered as basic or major, although the majority of dental plans list root canals as basic.
3. Major
Crowns, bridges, dentures, partials, surgical extractions and dental implants are considered as a major procedure by most dental insurance companies.
Always check to see which dental procedures fall under which specific category as some insurance plans don't cover major procedures. One important tip to remember is that if you know that you will need a major dental work, check to see if it is covered by a given plan, if not, you should try to look elsewhere and find one that best fits your needs.
Dental Insurance Waiting Periods
A waiting period is the length of time an insurance company will make you wait after you are covered before they will pay for certain procedures.
Missing Tooth Clause and Replacement Period
Most dental insurance policies carry a "missing tooth clause" or a "replacement clause." A missing tooth clause means that the company won't pay for the replacement of a tooth that was missing before the policy has taken effect. A replacement is somewhat similar with the exception that the company wont pay the replacement procedures until the specified time limit has passed.
Cosmetic Dentistry and Dental Insurance
Cosmetic dentistry which encompasses teeth whitening, veneers, lumineers and other procedures are done for vanity purposes only. While the effects are gorgeous, keep in mind that almost all dental insurance companies doesn't cover cosmetic dentistry.
Comprehensive Coverage
Before you decide on purchasing a dental insurance, talk to your dentist first. He will help you decide if purchasing a dental insurance would be the best option for you. After all, a dental insurance is not at all similar to a medical insurance. It is only intended for covering the most basic dental care needs and does not provide a comprehensive coverage like that of a medical insurance.
Dental Insurance Summary
Many dental offices are now offering zero-interest plans to help you with your finances on covering for your dental health because they know that dental insurances only cover small portion.
