When it comes to dental insurance and what is actually covered under your specific policy, many patients are unaware of what their coverage details really are until they’re standing at the billing desk of their dental office. Policies can vary between two different patients within the same company that provides their insurance, so making sure you are getting the most out of your policy can be confusing, to say the least.
Ensure you are getting the most out of your individual dental insurance plan by following these smart tips from Premier Dental.
The Basics of Dental Insurance
The first step in understanding your dental insurance coverage is determining what is considered in-network versus out-of-network coverage. Most benefit plans allow patients to select any dentist, yet only a specific set of dental office are considered in-network.
In-network. To be an in-network dental office, the practice has to agree to use specific treatments, materials, and to charge what the insurance plan deems as a fair and average price. An in-network dental office works with the insurance provider who chooses what treatments will be covered under the specific insurance policy.
Out-of-network. An out of network dental office can recommend and provide any dental treatments to patients and are also responsible for charging prices as they seem fair. An out-of-network dental office allows patients to have the flexibility to choose treatments that look and feel more natural as opposed to only being offered limited materials and treatments that will be covered. These attractive options and upgrades often end up costing the patient more out-of-pocket costs.
Knowing The Details Of Your Plan
Taking the time to review your policy details with a trusted dental office is often the difference between unexpected out-of-pocket costs and using the coverage you are paying for in your plan premiums. Most insurance plans cover regular preventative care at 100% coverage, so using your allowed two annual cleanings and exams is the first step in ensuring you are using the coverage you are paying for.
At the end of the year, your dentist may be able to split the cost of treatment between two plan years to make the most of your maximums, rather than completing an entire treatment in the same benefit year. If you have already met your plan deductible without reaching your coverage maximum, it may be a good time to invest in dental procedures you’ve been putting off so no money is left on the table.
Planning Your Maximums and Deductibles
One of the best ways to maximize your dental insurance benefits is to understand how your specific plan handles maximums and deductibles. Your plan maximum is the most money your insurance plan will pay towards your dental care each year. A deductible is the most money you yourself will need to pay out-of-pocket in a given year. If you’ve reached your annual deductible without exceeding the maximum plan coverage, it may be a great time to pursue certain treatments.
Scheduling Regular Exams
We engage our patients in the practice of preventative dentistry, meaning a cooperative effort by the patient, dentist, and dental staff. This helps to preserve healthy teeth and gums while preventing dental diseases, tooth decay and gum disease from taking hold. The key aspect of preventative dentistry includes strong oral hygiene, a balanced diet, and regular dental appointments for a healthy and beautiful smile.
Teeth Cleaning. Your dental cleaning will include removal of plaque, removal of calculus and teeth polishing.
A Thorough examination for tooth decay. We will view x-rays and scrape tooth surfaces to carefully check every tooth for any signs of tooth decay and cavities.
Examination of present restorations. We will examine your current dental restorations to check for any cracks or any other signs of wear or distress.
Gum disease evaluation. We will inspect the gums and bone below the teeth for signs of gingivitis or periodontal disease.
Examination of diagnostic x-rays. X-rays allow our dentist to detect tooth decay, growths, cysts, bone loss and whether the teeth and their roots are appropriately positioned.
Working With Your Dentist
Your treatment plan will include a breakdown of all applicable fees, and we will inform you of all costs before treatment is administered. We accept all credit cards and personal checks, as well as offer financing options through CareCredit, to help make your treatment more affordable. We are committed to building a lifelong healthy smile for our patients. Schedule your next dental exam and ask us about any confusion regarding your dental insurance benefits.