Do you still need to purchase a dental insurance plan? Is it a worthy investment? Having trouble deciding which plan is best suited for you? Don't worry we have put up a list of a few guidelines to help you in choosing the best plan for you.
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)
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.
If ever you chose to go to a participating provider, you should not be charged the extra for the dentist's regular price. This is because generally the company and the participating dentist have an agreement to write off the difference of the two prices. If you prefer choosing the dentist of your own, try to check the insurance's UCR fee guide. You may have to pay the difference out of your own pocket.
Dental Insurance Coverage Types
Most insurance companies categorize dental procedures into three groups:
1. Preventative
Routine cleaning and examinations, but sometimes X-rays, sealants and fluoride belong to the preventive dental care but can also be considered as basic depending on the specific insurance carrier.
2. Basic or Restorative
Most companies include fillings and simple extractions as basic or restorative dental treatment. Although root canals can sometimes be considered as basic or major, 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.
It is very important to clarify which dental procedures fall under which specific category. Some insurance plans don't cover major procedures and others have waiting periods for certain procedures. If you know that you will need a major dental work that is not covered by a given plan, you should try to find another 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 implement a "missing tooth clause" or a "replacement clause." A missing tooth clause means that if your tooth that was missing before the policy has taken effect, the company will not cover the replacement fees for that missing tooth. A replacement is similar with the except that the company won't pay the replacement procedures until the specified time limit has elapsed.
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 Wrap-up
Many dental offices are now offering interest-free payment plans so as to help you with your dental needs. But take into account these pointers and you will surely land that dental insurance plan that's perfect for your needs.
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)
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.
If ever you chose to go to a participating provider, you should not be charged the extra for the dentist's regular price. This is because generally the company and the participating dentist have an agreement to write off the difference of the two prices. If you prefer choosing the dentist of your own, try to check the insurance's UCR fee guide. You may have to pay the difference out of your own pocket.
Dental Insurance Coverage Types
Most insurance companies categorize dental procedures into three groups:
1. Preventative
Routine cleaning and examinations, but sometimes X-rays, sealants and fluoride belong to the preventive dental care but can also be considered as basic depending on the specific insurance carrier.
2. Basic or Restorative
Most companies include fillings and simple extractions as basic or restorative dental treatment. Although root canals can sometimes be considered as basic or major, 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.
It is very important to clarify which dental procedures fall under which specific category. Some insurance plans don't cover major procedures and others have waiting periods for certain procedures. If you know that you will need a major dental work that is not covered by a given plan, you should try to find another 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 implement a "missing tooth clause" or a "replacement clause." A missing tooth clause means that if your tooth that was missing before the policy has taken effect, the company will not cover the replacement fees for that missing tooth. A replacement is similar with the except that the company won't pay the replacement procedures until the specified time limit has elapsed.
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 Wrap-up
Many dental offices are now offering interest-free payment plans so as to help you with your dental needs. But take into account these pointers and you will surely land that dental insurance plan that's perfect for your needs.
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