Key Features To Consider When Choosing Dental Insurance
When you are reviewing and comparing dental plans its paramount that you choose a plan that properly fits your needs
. Different plans cover different things. All dental insurance programs have strengths and weaknesses, but it’s a question of what makes the most sense to meet the needs of you and your family. Most plans depend on the cost of your dental care each year, the problems/issues members in the family have treated, and how much each insurance plan will cost. The idea is to have the lowest possible out-of-pocket payments while receiving the best care you deserve. Virtually all dental insurance plans have some limit on what they will pay per patient, but he idea is getting the most of that plan based on you needs. That helps you know what to look for.
The first and main criteria when selecting a dentist is the question if the dental insurance limits the dentists you can choose to see. If so, it’s important to see if your dentist of choice is on that list
. It’s also important to know who controls the cost of treatment. Some plans let you and your dentist choose what is best for you, and others require your dentist to follow the “cheapest possible option” approach, even when those approaches are not in the patient’s best interest, or do not fix the problem long-term.
It’s also important to ensure that the plans cover preventative treatment costs and care such as regular screenings, x-rays, and cleanings. Having preventative treatment done can help save a lot of pain and suffering, as well as expense in the future. If the plan does cover preventative care (MOST do), it is also important to be aware of how much of that cost is covered by insurance and how much will be your responsibility. Knowing this key information can help you determine estimates of your out-of-pocket costs.
Most dental plans have some limits of how much the plan will pay in benefits per calendar year for each patient. Know what the limit is, because the rest is likely out-of-pocket costs to you
. It’s also important to know if the plan covers referrals to specialists in the dental field for work that is not able to be done by your traditional dentist. This is vital if major oral procedures are needed, or concerns about oral health arise. Finally, it is vital to see if this coverage just covers you, or if it includes everyone in your family. Knowing your whole family is covered is important to knowing what out-of-pocket costs you will incur.
For more information on these specifics, ask your dentist for more information. If they do now know the information to these basics off-hand, they may not be a great choice for an oral health care provider.
Limitations Of Dental Insurance Plans:
Virtually all dental insurance plans will have limits as to how many benefits each person or individual can claim per year. Sometimes insurance plans will also provide a cost-sharing program that allows the cost to be shared among family members, but those plans are also generally capped at a certain value. This is how insurance plans control costs. The rest of the expenses of dental treatment beyond that cap limit are likely covered out of your pocket. It’s also worth noting that all plans exclude experimental treatments that are not proven to work, and those procedures not approved by the government. Those will be out-of-pocket costs. Also check with your medical insurances, as some plans may cover costs dental insurances won’t to save you paying out-of-pocket unnecessarily.
Points To Consider About Dental Insurance:
When choosing a dental plan, it’s important to work with the plan purchasers to regularly review that the UCR or Table Of Allowances payment schedules are equitable. This keeps costs affordable while optimizing benefit levels to ensure every dollar the patient spends works to its full capacity.
It’s vital that the patient notifies the administrator of your main insurance provider if you are covered under more than one insurance plan. Insurance plan benefits coordination will help protect your rights and ensure you receive the maximum benefits you are entitled to. Insurance coverages may overlap to provide full coverage if the main insurance policy doesn’t cover everything.
Odd as it sounds, it’s actually wise in most cases to choose an insurance plan with a financial limit to it. Many other insurance plans will exclude entire categories of services. If you need one of those services you will likely pay a lot more for that procedure than you would paying overflow costs from a plan that covers a percentage of all procedures.
If you have issues with what you are being charged, the good news is that most insurance plans offer services to help dispute any charges you may question to help settle costs
. It’s much cheaper than court costs, and helps stretch every dollar to go to patient services.
If you have any questions regarding this topic feel free to contact us
and/or call us 909-465-1016
The Ramona Dentistry Team
“Where Family Comes First”