Dental Insurance – A Must Have or Not
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.
Affordability and Yearly Maximum
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)
Very common among dental insurance companies use what is called a Usual, Customary and Reasonable (UCR) fee guide. This means that the fees covered for every dental procedure is based primarily on the company’s discretion, oftentimes based not on what the dentist charges, but on what the company wishes to cover.
Should you choose to go to a participating provider, you should not be charged extra for the dentist’s regular price. This is due to the agreement of company and the participating dentist to write off the difference of the two prices. If you prefer to choose a dentist of your own, always check the insurance’s UCR fee guide.
The 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
Most dental insurances include crowns, bridges, dentures, partials, surgical extractions and dental implants as a major procedure.
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
Waiting periods are periods at which insurance companies 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
Teeth whitening, veneers, lumineers and other procedures under cosmetics dentistry are done for vanity purposes only and almost all dental insurance companies doesn’t cover them.
Comprehensive Coverage
Before deciding to purchase dental insurance, talk with your dentist about the full extent of the dental plan. Take note that a medical insurance is different from a dental insurance, which are designed only to cover the basic dental care per year and does not provide comprehensive coverage like that of medical insurance plan.
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.
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