Dealing with insurance companies is always a headache, and setting up your dental plan is no different. There are many factors to consider. Do you need basic coverage, or do you have complex health needs? Do you need to combine different types of insurance together? Is your insurance coming from an employer, or are you on your own? Do you need a family plan? Not to mention the difficulty in figuring out what's actually covered under any particular plan. It might be enough to make you want to forgo dental insurance altogether, but this is never the best option. Emergencies arise without warning, and dental work becomes a much bigger issue the longer you ignore it.
Let Flintlock Dental help with this basic guide on shopping around for dental plans. Whether you just need annual checkups or often require dental surgery, there are ways to get the most out of your dental plan. Let’s look over some of the ways you can go about using your dental plan to maximize its benefits and get the care and coverage you need!
Take the Time to Understand Your Coverage
How much you spend on your insurance each month is not the only expense you should take into consideration when choosing an insurance policy, and there are a few terms you need to be familiar with before shopping around.
- A deductible is how much you have to pay before insurance kicks in. This applies to most visits other than preventative ones that are covered for free, such as annual checkups.
- Copayments are what you pay for each visit to a medical professional.
- An out-of-pocket maximum is how much you can pay in a year before insurance will pay for 100% of all further procedures that year.
- Some plans have an annual maximum, which is the largest amount the insurance will pay for each member of the family that’s covered under the plan. This is something to watch very closely, so you can plan out visits accordingly.
With these factors in mind, it’s easy to see how different types of plans can widely differ on how much money you will spend in a year that requires more than the bare minimum medical service.
There are two main plans to choose from when you go to sign up for dental insurance:
HMO (Health Maintenance Organization) - This type of plan requires you to choose a dentist inside your primary care network to handle most of your care and needs. Using this plan charges you a relatively low co-payment for office visits and procedures. You are charged extra if you use an out-of-network dentist. Most times, an HMO plan does not include a deductible or has a very small one.
PPO (Preferred Provider Organization) - Using a PPO plan, you have more flexibility in choosing different locations for medical services. Once you hit your deductible on this type of plan, you will be reimbursed some of the charges for office visits and procedures. The amount reimbursed will depend on treatment and dentist location.
Know What’s Covered in your Dental Plan
Dental insurance can cover everything in oral health from preventative care to orthodontics. Making sure your coverage includes the care that you and your family members need is important, so that you pay only for what you need and not too much for unused extras.
The first feature to check on your dental plan is how many routine visits and what type of preventative care is completely covered. Take advantage of these included services, since you’re already paying for them with your monthly bill. They are important for maintaining your oral health, preventing painful and costly problems down the line, and can uncover issues that need more attention before they become even worse. If you don’t go to these annual checkups, small problems will become much bigger and cost more money. This is why a good dental plan covers your annual visits in full – the insurance company wants your mouth to stay healthy just as much as you do (so they don’t have to pay more for bigger procedures)!
If you find that you need more work done through orthodontics, check how much (if any) of your dental insurance covers these visits and procedures. This type of care for your teeth often ends up costing thousands of dollars, so if you think that there’s any chance that anyone in your family will need such care in the near future, it’s a wise idea to go ahead and make sure this is part of your coverage inside your dental plan now.
Control Expenses and Payment Plans
No matter how great the dental coverage, you want to make sure you are maximizing the benefits. This includes using a dentist inside the coverage area to help keep your costs low on an HMO plan. You should be familiar with your deductible, copayment price, and annual maximum limits, so you can plan your yearly finances around your procedures. Some dental offices will set up payment plans, so you can control the costs even more if there are continual treatments needed throughout the year.
Knowing your dental coverage and choosing the right plan for you and your family can save you thousands of dollars each year while providing you with the best treatments when you need them. Make sure you understand your coverage and are getting what you can out of it. As always, it's important to keep up with your annual dental visits, so that you don’t end up paying for more extensive and painful treatments later down the line.