Insurance is not the most desirable topic to discuss. However, having a proper understanding of the way dental insurance works might alleviate your anxiety and encourage you to get the necessary preventative, restorative or emergency dental procedures you need to stay healthy. Whether you currently have dental insurance or you are shopping the market for one that fits your family’s needs best, here is some basic information to help you get started on gaining an understanding of how it all works.
Is your dentist in or out? Using an in-network dentist means your services will be covered or recognized by your insurance provider. Most of the time, an insurance specialist at your dental office will submit your claim for you on your behalf. When your dentist is out of network, you can expect to pay for your dental procedures up front and you will need to personally submit your claims for partial reimbursement.
There are a few commonly used terms when it comes to health insurance and dental insurance is no different. A clear understanding of these will help you decipher your plan and help you budget accordingly for upcoming dental work:
- Maximum: This will pertain to the set maximum dollar amount that a dental plan will pay toward the cost of dental care during a specific benefit period.
- Deductible: A deductible is the amount of money you have to pay out of pocket before your dental insurance benefits will start contributing to the cost of your treatment.
- Coinsurance: This represents a set percentage for the cost of your treatment that is paid by your dental insurance benefits; you are expected to pay the difference or remaining balance. You will be responsible for any charges over the allotted coinsurance even if you have met your deductible.
Be sure to note what is not covered under your plan. For instance, many dental insurance providers do not cover cosmetic dental procedures. If this is the case, ask your dentist about payment plans or other financial aid.
At Gilreath Family Dentistry, we are happy to discuss your current dental insurance coverage or help you choose a dental plan that fits your budget and projected dental needs. A senior adult who is facing tooth replacement options may need a very different plan than a healthy family of young kids that will most likely need just routine maintenance dental visits for the next few years. Perhaps one of the most important facts to remind yourself is that if you have dental insurance and you skip your routine six-month dental checkups, then you are wasting valuable coverage that most dental insurance companies provide. Are you getting the most out of your coverage? In more times than not, taking advantage of your preventative coverage now means eliminating costly dental procedures in the future.
Posted on behalf of Dr. Paul Gilreath IV,