Dental Health: 8 Things You Didn't Know About Dental Insurance

August 16, 2022

From a young age, you are told to brush your teeth in the morning and evening, and after every meal, you should gurgle and floss. This is all meant to ensure that you maintain healthy teeth and oral health.

Studies show that 65% of adults visit a dentist at least once a year, which shows that most Americans care about their dental health.

As part of taking care of your dental health, dental insurance is crucial as paying out of pocket can be quite expensive. Therefore, take the initiative to learn more about dental insurance and what it covers and doesn't.

Let's look at what most people don't know about dental insurance.

What Do You Understand By Dental Insurance?

This is the type of insurance plan is where you pay a monthly fee to get dental coverage for a year. The extent of coverage depends on your program of choice, as there are several. And most come with a deductible or co-pay, which is an amount you pay out of pocket. And the more you pay, the more your insurance covers.

Types of Dental Insurance

There are three types of dental insurance plans, and they include:

●  HMOs
Dental Health Maintenance Organization (HMOs) is a plan that has a network of dentists that accepts insurance with no out-of-pocket charges. However, they do not allow you to see a dentist not listed in their network.

●  PPOs
A Preferred Provider Organization (PPO) is a plan where the dentist you choose has to accept the plan. With this insurance option, you have the freedom to choose a dentist not listed in the network. However, you are bound to incur higher co-pay or out-of-pocket charges.

● Discount dental plan
This is an insurance plan where you are given a discount on dental services when you visit a select group of dentists. The insurance provider does not pay for your care. Instead, your dentist agrees to offer you a discount for their services.

8 Things You Didn't Know About Dental Insurance

Many things are tied to insurance; most times, people don't take the time to understand the type of insurance they are procuring. Below we discuss some things people don't know about dental insurance.

1. It’s Important to Compare Insurance Providers and Dentists

Before settling for any insurance provider for a dental plan, you must research and compare different programs and costs and choose the one that's right for you.
For instance, ePlatinumHealth Health Insurance Agency - Medicare - 5 Star Rating is an excellent insurance provider.

You must also look at various dentists and choose the one that fits your needs. Comparing providers and dentists will help you save some costs as the prices differ.

2. It Provides Full Coverage for Some Treatments

Note that your dental insurance covers most dental services costs, such as teeth cleaning, fillings, and checkups. So, you don't need to pay much to have healthy teeth.
However, you will have to pay a lot more for other services, such as chipped teeth or mouthguards.

3. It's Grouped into Four Categories

• Direct reimbursement
The patient is paid a certain percentage of the amount they spend on dental treatment, irrespective of the kind of treatment. This program also allows patients to see a dentist invested in their dental health and gives them economical dental health solutions.

•  Usual, customary, and reasonable programs
The UCR program allows the patient to choose their dentists. And the plans pay a certain percentage of the fees charged within a reasonable limit.

•  Schedule of allowance programs
With this program, patients are allowed to see their dentist of choice. However, the number of services is limited, and coverage is limited. And service outside of the list is covered by the patient.

•  Capitation programs
The contracted dentist is paid a fixed amount every month for all the families enrolled, and in return, the dentist offers a list of services as specified in their agreement.

4. Has a Cap on What They Can Pay Per Year

Every insurance plan, dental included, has the maximum amount they are willing to pay per annum. And if you exceed that amount, the balance comes out of your pocket

5. Many Workplace Insurance Programs Offer Braces Allowance

Many people's teeth are not well aligned, so they must wear expensive braces. Many people don't know that many workplace policies have a dental braces allowance ranging from $1,500 to $2,000.

However, in most plans, the allowance is a one-time offer, so take advantage and get yourself a smile-worthy dental formula. Consult your employer to see if such an offer is available in their plan.

6. They Have Waiting Periods

Most insurance plans have a waiting period for certain services, dental included. So if you are procuring medical insurance eager to have your teeth attended to, you are in for a disappointment, as you'll be required to wait for a certain period before the insurance can cover your dental expenses. So ensure that you have clarified your waiting period before paying for a plan.

7. Does Not Roll Over If Unused

If you have dental coverage, use it even if it's for a checkup or teeth cleaning because once the year is over, the plan will not roll over to the following year. In other words, if you don't use it, your money will have gone to waste.

8. Does Not Offer Some Services

Unfortunately, some services are not covered by your dental insurance plan as they are more focused on preventative treatment. Therefore, if you procure a dental insurance plan for cosmetic treatment, you are in for a rude shock as they do not provide coverage, and even if it does, it's meager.

However, if you want restorative surgery such as composite filling or porcelain, your plan only covers a small amount, and the rest comes out of your pocket.
Note that the amount dispensed by your provider is really low, so you must decide on the services you want to receive.

Final Thoughts

Take care of your oral and dental health to avoid visiting your dentist because of cavities or other dental issues. However, you still need to schedule regular dental visits.
To lessen the burden of paying the dentist, procure dental insurance from a reputable provider. Hope this article has been able to make you at least a little bit more knowledgeable about dental insurance than you were before!

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