What’s Your Dental IQ?

bulram | August 6, 2012

Do you know the ins and outs of your dental insurance plan? Many people carry dental insurance and do not know exactly what is or isn’t covered. They don’t take the time to research prior to having work done. When slapped with a huge dental bill, they become upset. You can avoid this problem by taking the time to learn about your dental insurance.

Preventive Services

Many policies will pay for preventive services at no cost to you. Preventive services usually cover oral examinations, cleaning and X-rays. Most policies will only cover one cleaning every 6 months. If this is true of your policy, be sure your appointment dates follow the timeframe or you will be denied. Many policies will only cover one set of X-Rays per year.

If preventive services are a part of your plan, you should not have any out-of-pocket fees if you follow the time frames.

Deductibles

Other basic services like fillings, oral surgery and extractions may be subject to a deductible. After the deductible is met, the plan will pay a certain percentage, i.e. 80%. You will then be responsible for paying the remaining 20% (plus the deductible).

Major services like crowns, dentures, bridges and orthodontia may be subject to a deductible as well. However, oftentimes, the plan payment will be reduced. For example, the plan may only pay 50% of these charges. You would be responsible for the remaining 50% (plus the deductible).

Annual Maximum and Waiting Periods

Most dental policies have an annual maximum. Generally it is $2000/year. That is the maximum paid in any calendar year. The reason for this is to avoid abuse of the policy. People will get their dental work completed, then drop the policy. This is also the reasoning behind waiting periods. Some policies require you to wait a certain amount of time before you are eligible for certain high-dollar services like dentures, bridges, etc. When there are waiting periods, the insurance company is making sure that you are significantly paying into the plan before you are eligible to receive benefits for those services.

PPO and HMO Dental Plans

Yes, there are PPO and HMO dental plans, just like medical plans. The PPO plans normally require you to use network providers to receive the maximum payment for your services. Usually when you go out of the network, the payments are reduced.

HMO Dental plans usually pay a flat rate per procedure. The patient will be responsible only for an office co-pay amount and the flat rate would be paid for the procedure. Preventive services will have no costs–just like the PPO plan. Keep in mind that the HMO network is normally a lot smaller than the PPO network. You must use a network dentist in a HMO dental plan. If not, the plan will not pay any benefits.

Now that you’ve learn something new, take the time to go and review your policy before you have your next dental appointment.

Author’s bio – Lisa Collins a well known writer has been writing numerous articles on health insurance. for more information on different health insurances visit the website Dentalinsurance.net .