Dental Insurance Plan Access

Dental insurance is offered in a wide variety of options. You may have dental insurance options through your employer or you may go online to purchase a policy. There are discount dental services. There are non-profit organizations that help set up clinics across the U.S. to help the neediest.

  • If you are not interested in dental insurance, you can be proactive with preventive dental cleanings for $300 per year and cash pay for any restorative needs that come up along the way which could be as much as $25,000 in the end.
  • If you are interested in dental insurance, you can maintain your oral health with professional dental hygiene visits to prevent spending up to $25,000 or more for restorative dental procedures or cosmetic dentistry.

What You Need to Know About Dental Insurance Plans

Dental insurance policies vary in terms of the type of coverage, the options for selecting a dentist, deductibles and premiums. The good news is that you have the freedom to select from a wide variety of plans. So, first you can identify what’s important to you in your plan and then direct the appropriate questions to prospective dental insurances companies which can b found online or your employer, including;

1.  Each year, how much am I able to spend for dental treatment? In other words, what is my annual insurance cap?

2.   Each year, is there are limit on the number of times I can see a dentist and number of times I can have x-rays?   How much of those dental costs does your plan cover?

3.  What types of treatment may I be able to receive under your insurance plan and at what percentage of the costs do you cover for those treatments, including, preventative dentistry and restorative dentistry? For example, preventative dentistry, such as, teeth cleaning is often covered at 80% to 100% whereas tooth restorations may be covered at 50% with an annual cap including both.

4.  Are there certain dental procedures in which you limit cost coverage due to the use of advanced dental technology, such as, tooth colored dental filling which may be $30-$50 more than silver amalgam dental fillings?

5.  Does you dental insurance policy cover pre-existing conditions?

6.  Am I allowed to select my own dentist? If so, do I pay a co-pay flat fee for treatments and what are the co-payment amounts for each type for preventative and restorative dental procedure?

7.  If I am not permitted to select my own dentist, can you provide me with a list of your network dentists and facilities so that I can review the dentist’s credentials and availability of technology to make an informed decision? Is this a PPO (preferred provider) network of providers and how does that compare to an HMO?

8.  Do I need to pay any upfront costs to my dentist and then submit my expenses to your insurance company for reimbursement?  Instead, can my employer reimburse me through a Direct Reimbursement Plan option?

9.  Can you tell me about Dental Care Service Plans that are non-profit organizations to provide dental treatment at set fees?

10.    If I need cosmetic dentistry, such as, dental veneers for restorative purposes, will your insurance company cover all or a portion of such costs?

11.    If I need a smile makeover with full mouth reconstruction of outdated and worn out dental restorations or a poor bite, will your insurance company assist in absorbing some of those costs?

It’s important to decide on your insurance and select your dentist before going to a dentist for treatment to maximize cost savings. For as little as $60.00 per month, you may be able to obtain a dental plan online that will absorb substantial costs for you, particularly if you need restorative procedures. By the same token, it is not recommended to refrain from preventative, restorative or emergency treatment. Regardless of your insurance situation, your dentists finance manager will typically do everything possible to assist you with payment options, such as, patient financing.

After you have received dental services, you will notice an explanation of the fees that your insurance agreed to pay.  Often, insurance companies identified what is considered Usual, Customary and Reasonable (UCR) charges and pay dental providers at that level.

Your employer may also have a flexible spending account in which you can place a percentage of you income into that account to help cover future dental expenses.

 

It is important to recognize that all information contained on this website cannot be considered to be specific medical diagnosis, medical treatment, or medical advice. As always, you should consult with a physician regarding any medical condition.