Dental Insurance Articles
Choosing A Dental Insurance Network
2010-05-21
With rising costs associated with dental work, many Americans are opting for dental insurance plans, either group or individual. However, understanding what is covered under your insurance plan and any stipulations will be essential to satisfaction with the insurance network you select. You may wish to consider the following points while you research various plans.
Yearly Maximums
Many dental insurance plans impose yearly maximums, which is simply the maximum amount the company will pay over the course of one year. Often, any excess amounts left over at the end of the year do not roll over, so it will be important to schedule appropriately and to pay attention to these maximums to avoid wasting money and to control your out-of-pocket expenses.
Categories for Dental Insurance Procedures
Most dental procedures fall into three (3) categories: Preventative, Basic (or Restorative) and Major Dental. Let's explore each. Preventative care is the type of dental care designed to prevent dental problems in the future. Cleanings, dental examinations, x-rays and fluoride treatments generally fall in this category. Basic dental care usually includes simple procedures such as basic extractions and dental fillings. Some dental plans also list root canals under this category. Finally, major dental includes more detailed procedures like dentures, dental implants, crowns, bridges, partials and dental surgery. Different carriers categorize these procedures differently, so be sure to read carefully before proceeding. A fourth category, Cosmetic Dentistry (including teeth whitening which is increasing in popularity) is often not covered by insurance.
Is Your Dentist In-Network or Out-of-Network?
Depending on the plan you choose, some insurance companies require you to obtain services from dentists within their network, while others will allow you to select your own dentist. These networks can readily provide you with a list of their in-network dentists, making it easier to choose whether or not you'd like to work with their providers. If not, be aware that many work within a fee guide referred to as usual, customary and reasonable. This means that they have assigned a certain cost to each dental procedure, so any differences in fees from your out-of-network dentist will usually result in out-of-pocket expenses for you. These fee structures are usually pre-negotiated with in-network dentists and therefore present no out-of-pocket expenses.
Clauses and Other Considerations
If you have one or more missing teeth before your policy began, insurance companies can deny corrective procedures (on the same premise as pre-existing conditions on your medical policy). Some insurance networks impose waiting periods; check with your dentist regarding the procedures you may need, when they're needed, and if they offer interest-free payment plans to cover other dental expenses. Consider all of this information when looking for dental insurance that you are better informed in your decision.