Dental Insurance Articles
Copayments And Why They Are A Part Of Dental Insurance Plans
2010-11-27
Dental insurance is designed to assist individuals or families by offsetting the high cost of dental services. There are several different types of dental insurance plans available that an individual can choose from. Dental insurance rates will differ depending on the type of plan that you choose to purchase. Some of the most common plans are those that utilize dental insurance co-payments.
A co-pay means that the insurance company will pay for a set percentage of dental services or treatments and the plan member is responsible for the remaining amount. Depending on the insurance company, the member may be given an insurance card to present at the dentist that will automatically deduct the insurance company's portion. Then, the member will have to pay the outstanding amount as services are received. If the insurance company does not provide this option, then the dentist may bill the patient for the full amount immediately, and then the patient can submit a claim form along with the invoice to get reimbursed.
For basic dental services, the insurance company will normally pay a majority of the bill, which can be 80, 90, or 100%. Basic services and procedures include x-rays, tooth extractions, or fillings. However, for more extensive services, the co-pay amounts may be split 50-50. This is an important part of the contract that you should discuss with your insurance agent before finalizing your purchase. These more comprehensive procedures can include such things as crowns or dentures.
Dentists recommend that individuals get a dental check up at least once every six months. This check up usually involves the most basic of dental coverages and is meant to be mostly preventative care. The more diligent a person is with their dental care, the healthier their mouth and teeth will be. Infections, cavities, and poor oral hygiene can lead to more serious heath problems, which can cost both the individual and insurance company more money in the long run.
Co-payment amounts are lower for more extensive procedures in order to prevent people from seeking certain dental treatments when they are not really needed. It helps to reduce the chances of insurance fraud and unnecessary claims. Otherwise, people would be having dental work done for mostly cosmetic reasons and claim through their insurance companies. This would, in turn, cause dental insurance rates to increase. Dental insurance co-payments can help keep these rates low so that more people can afford insurance as well as discouraging abuse of the system. The best way to determine if a co-payment dental insurance plan is the best option for you is to thoroughly discuss all available plans with your insurance agent.