Considerations in Choosing a Dental Plan
Information to help you, from strive4impact.com
Dental Plan Descriptions
Here's the drill on choosing a dental plan
When you choose a dental insurance plan, you're also choosing a type or category of plan with its approach to the provision of benefits and payment for dental care services. For example, the indemnity plan allows you to chose any dentist, while the pre-selected dentist plan requires you to select and always use the same contracted dentist. Call the carrier's member services if you have a specific question.
When comparing plans, check premiums and benefits to predict your possible costs for the balance of the plan year. You only pay deductibles if you use benefits through the dental plan, and co-pays (Indemnity only) and out-of-pocket expenses.
Once enrolled, review all the materials that are sent to you so that you understand the terms and conditions before using the dental plan services. Should you have any issues at any time throughout the year, contact your carrier's member services department. They are there to serve you.
Considerations for enrolling in an Indemnity Dental Plan
An Indemnity plan pays established benefits when you seek covered services from any licensed dental provider, not just from among those in a contracted status with the carrier.
There is an annual deductible, then the plan will pay a percentage of covered charges; and you'll pay the balance. If the provider bills more than the plan allows, you will be responsible for any charge over the plan's allowed amount for each procedure code.
We have an additional benefit with our indemnity dental plans. It includes the benefit that you will not be charged a higher amount than that which the carrier says is usual, customary and reasonable, provided you use one of their contracted, preferred providers (PPO). Benefits will be paid at 80% or 50% of usual, customary and reasonable charges, subject to the yearly or lifetime limit depending upon each procedure.
Considerations for enrolling in a Pre-selected Dentist Plan
These plans require you to select a dentist from a list of contracted dentists. You must always use that dentist for your entire dental needs. You may change your primary dentist during the plan year, by selecting another dentist from the list and then notifying the dental plan's member services office. If your selected dentist determines that you need to see a specialist, then the services required will be covered as specified in the plan booklet.
The plan booklet lists your out-of-pocket expenses for any required procedure. The charges are reduced fees. That is, a reduction in what would other wise be charged.
The majority of dentists who contract with these plans require that you be on their patient roster, before a appointment can be scheduled. The plans update rosters on a monthly basis. However, if you are new to a plan, or change dentists, and not on your selected dentist's roster, and have a dental emergency, you can call the plan's member services office for referral to a dentist.
Dental insurance is designed as a financial assistance for your dental needs. Insurance should not determine your dental care and treatment. For example, you may require 3-4 cleans per year to control tooth decay or gum disease. Insurance may pay for only two appointments. You will need to contribute financially to maintain optimum oral health. Be informed.
Dental Insurance Selection and Use
Can you choose your dental office or must you choose from a list? Are you allowed to see specialists and how many are available on your plan? How many providers in your area? Are there co-payments for many services? Ask and Compare.
Remember - insurance coverage is just a partial assistance toward good oral health.
Know your benefits - read your policy and compare.
Know your options - limitations and
exclusions of your dental plan.
Practice good oral hygiene- follow the advice of your registered dental hygienist and dentist.
Provide feedback- let others know of your experiences.
Ask questions- be interested and involved in your own health. Ask for option alternatives at your insurance renewal.
Maintain Good Oral Health
Most dental plans provide coverage for selected diagnostic services, preventive care and emergency treatment. These services are basic for maintaining good oral health. However, depending on your dental plan, the extent or frequency of the services covered may be limited.
You may be required to pay the dentist directly for a portion of the basic care, depending upon your individual oral health needs. Good dental health is worth the investment.
Every dental care plan is different. Familiarize yourself of the benefits of your dental plan to maximize your coverage. During the negotiation and/or renewal of your coverage, ask about different options and alternatives for your insurance package.
Remember - the registered dental hygienist is an important part of your dental visit.
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