Before you schedule your visit with the dentist, you need to make sure that you understand what your dental insurance policy covers. It may not be the most exciting reading you ever do but if you are not familiar with your benefits, you will not be getting the most out of them.
You Don’t Benefit from Coverage you Don’t Use
Your dental insurance plan is meant to be used. If you are paying for part of your coverage through your work or you are funding it yourself, make a point of going to the dentist for checkups and preventive care. This is cheaper in the long run than putting off seeing someone until you are in pain or a problem becomes a bigger one that is much more expensive to treat.
What Services are you Covered For?
Depending on your policy, you may have a no-frills plan that covers you only for basic services like exams, cleaning, fillings, scaling, polishing, root planing and diagnostic services. A top-of-the line plan would provide you with the basic level of coverage, plus reimbursement for endodontics, periodontics and dentures. It will likely also cover services like dentures, orthodontics, crowns and bridges.
What Percentage does your Plan Cover?
Your insurance plan will not cover the entire cost of your dental care, which means you will still be responsible for a portion of the services your dentist provides to you. This percentage will vary, depending on your contract with your plan provider.
In some instances, the level of coverage you have depends on how long you have been a plan member. During the first calendar year of coverage, you are reimbursed at a lower rate than during the second one. Your level of coverage may increase up to a maximum level during the fifth calendar year.
What is your Annual Maximum?
A dental insurance plan will have some type of annual dollar limit for the amount it will pay out in benefits for each person it has enrolled under its plan. You’ll want to make sure that you find out whether the annual limit applies to the anniversary date that you enrolled or the calendar year.
Once you know the date, you can make it work for you. For example, your plan calculates its annual limit by anniversary date and you joined the plan as of May 15. Your annual limit is $1,000.00. If you know you need dental work done, arrange to have part of it done in early May to use up the last of your dental benefit for one year and the rest completed after May 16 to start using your following year’s benefits; you’ll have another $1,000.00 to work with .
By getting familiar with your policy and the type of dental insurance coverage you have, you will be able to get the care you need to look after your oral health.
