Dental Insurance - A Must Have or Not
With the rising prices of just about everything nowadays, it’s really a wise decision to prioritize the things that are more essential and consider which things you can do without. One example is whether you need to purchase a dental insurance plan or not. Either you get one on your own or as a benefit from your company, its important to consult the following pointers before signing on the dotted line.
Affordability and Yearly Maximum
The yearly maximum is the at most amount that the dental insurance plan is willing to pay during the whole year which automatically renews the next year, but if you have unused benefits, those wont carry over.
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)
Common among dental insurance companies use a Usual, Customary and Reasonable (UCR) fee guide. This lists the prices (often based on their own decision rather than on what the dentist charges) they are willing to allow for every dental procedure they will be covering.
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 categorize dental procedures into three groups:
1. Preventative
Routine cleaning and examinations belong to this category, but sometimes X-rays, sealants and fluoride can also be considered as preventive or basic dental care. It depends 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.
Note that some insurance plans don’t cover major procedures; others still, have waiting periods for certain procedures. That is why it’s very important to clarify which dental procedures fall under which category. If you know you will need a major dental work and that procedure is not covered by a certain plan, try to find another that best suits 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
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
To help you with your finances on covering for your dental health, many dental offices are now offering zero-interest plans that compensate the small portion that dental insurances cover.
