Choosing a dental insurance policy is very important— almost as important as flossing and brushing your teeth to maintain dental hygiene. Some people assume that dental insurance is not that important as compared to medical insurance.
Yes and no, is all we can say.
If you are in the same boat, then you are forgetting that medical insurance does not cover any kind of dental procedures. We all know how a simple cleaning or crown removal can be so expensive. So, do you really want to spend thousands of dollars on your kid who eats too much candy?
Yes, that is what we thought.
Think of your dental insurance policy as a simple plan for basic and preventative services. The small procedures will be completely free and any big ones will require a small amount of money from your pocket.
Are you with us so far? Here are five tips that can help you get the most out of your dental benefits:
Pick the Right Plan
Let’s have a look at the two most popular dental plans:
Preferred Provider Organization (PPO) plan and Health Maintenance Organization (HMO) plan.
Here’s how a PPO plan works:
- Along with your monthly premiums, a deductible needs to be in order to kick start the insurance. These deductibles are typically less than $50 and don’t apply to only preventative services
- There is an annual limit on the coverage, which is usually $2,000 or maybe less, depending on what services you want in the cover. This the only amount the insurance agency will pay in a year for all your dental procedures
- Yearly preventive services such as cleanings can be availed twice and are fully covered
- For other extensive procedures, you have to pay a small cost. For example, for filing, you pay 20% of the cost and for a crown 50%
Here’s how an HMO plan works:
- The premiums are lower
- You might not have to pay deductibles
- For every treatment, you will have to pay a fixed co-payment
- The benefits offered are less too
We suggest that you choose an HMO plan. Why?
One of the biggest drawbacks of an HMO plan is that the network of dentists available is very small.
You are probably wondering how small, right? Well, 90%!
In fact, the treatment options offered under HMO are also way less. For example, let’s assume you are going to a dentist for a crown replacement. You browse the crowns and the dentist recommends the metal crown. However, you spot a ceramic crown and want that one because it blends in better with your teeth. The dentist then informs you that you will have to pay extra for the ceramic crown because it is not fully covered under your dental plan.
As an individual adult, you might not give dental insurance a second thought but as a family person with children, you need to choose a cover that provides more benefits. Now that you have chosen a cover, you need to understand its clauses. For instance, your coverage allows you to have two annual cleanings. What’s the timeline for these cleanings? Can you have them within a month or two months’ time, or do they need to be six months apart.
Stay in the Network
The best way to take full advantage of your dental insurance plan is to ALWAYS stay in the network. Whether you have a PPO plan or an HMO plan, you will benefit more from going to a dentist that is on the list provided by your insurance agency. If you have an HMO plan, then know this: you will not receive any coverage for a dental procedure done out of the network.
In a PPO plan, you will receive the best coverage from the dentists in the network and the best discounts on the expenses you pay out of your pocket. As for going out of the network, you will still receive a certain amount coverage.
After you have enquired about the procedure, ask for an estimate of the treatment plan. This will tell you how much you will pay.
Timing is Everything
It often happens that you get a procedure done, and when you file a claim for reimbursement, you are informed that your insurance plan does not provide coverage for it. To avoid this sort of confusion, it is better to schedule your procedures.
For example, let’s assume that your dentist has recommended two crowns and four fillings. If you get them done all at once and in the middle of the year, you will reach your coverage limit and spend more out of your pocket. However, if you space the procedures and get 3 done in November, you will have time to recover. A policy usually renews by the 1st of a new year, so you will have full coverage in January.
Discuss your treatment options and timing with the dentist before getting a procedure done.
This is pretty self-explanatory. Try to visit at least three dentists and get quotes about the procedures. Once you have an idea about all the expenses, you can decide on which dentist to go with. It’s important to care about prices because a simple dental procedure can cost you thousands of dollars.
Dental procedures are like black holes. When a cavity is discovered, the dentist finds it going deep. It starts with simple cleaning, proceeds to extraction and then replacements. Do check websites to get more information about the procedures to estimate the total cost of the procedures and a list of pros and cons of every dentist.
You can get discounted plans through insurance agencies that give you access to a few dentists, who will perform procedures at a discount. Depending on the complexity of the procedure, the discount can be either up to 20% or 30%. In some cases, the discount rate might be high.
And there you have it – five tips on how to choose the right dental coverage. If you want to know more about dental coverage, then check out our blog for similar topics. If you are looking for an insurance provider that will help you design your dental insurance coverage based on your needs, then visit Pawson. The company provides different types of insurance policies for families and individuals. To know more about their policies, contact them at 203-481-8898.
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