When buying a dental insurance plan there are many factors that should be looked at so that you get the best plan for you and or your family. One of the primary focus should be to determine whether the dental plan coverages will satisfy your dental care needs. Ask these questions to yourself when reviewing a dental insurance plan and know the answers before buying one. Doing this can save you money as well as any unnecessary grief.
1) Does the plan give you the freedom to choose your own dentist or are you restricted to a network of dentists selected by the insurance company? This is important to know if you are trying to stay with a family dentist that you are satisfied with. In the same regards it is important to know what types of dental plans your dentist takes and whether or not they are a network provider of any plans.
2) Know the plan benefits and what is cover and who controls any treatment decisions. There are many dental insurance plans that require dentists to follow treatment plans that rely on a least expensive alternative treatment approach. (Example) If there are multiple treatment options for a specific dental condition, the dental insurance plan may only pay for the less expensive treatment option. Therefore if you choose a treatment option that may better suit your individual needs you may be left responsible for paying the difference in costs or even the total cost for the dental service. It’s important to know who makes the treatment decisions under your plan.
3) Know the plans coverages and limitations. Many plans like PPOs or Free choice of provider plans have maximum annual dollar limitations, waiting periods and deductible. Many of these types of plans out based on percentage up to UCR (Fair and Reasonable or Maximum Allowable Charge) for the different dental services. Where other dental plans may schedule out the cost for services showing the cost a member pays for each type of dental service covered.
4) Does the dental plan allow referrals to specialists? Not all dental insurance plans cover the cost for dental specialists. There are times when a dental services such as root canal or tooth extraction requires a specialist. In such cases does the plan offer coverages to specialist? If so what are the coverages for specialist? In many cases coverages are reduce when seeing a specialist so this is important to know and understand before buying a dental plan.
5) Does the plan provide benefits to patients who may also be covered by another dental insurance plan? Not all dental plans offer dual benefits. So when searching for a secondary dental plan make sure both plans allows for coordination of benefits. Also make sure you are seeing a dental provider that is willing to process dual plans.
6) Know what is not covered under your dental plan. Be aware of any restrictions when choosing your plan. Such as: No specialist, No preexisting (Missing Tooth clauses) No work in progress. Many dental insurance plans will not offer coverages on cosmetic dental services such as whiting or veneers or implants. Other restrictions on coverages could include treatments of complicated periodontal disease requiring surgery involving bones, underlying tissues or bone grafts.
7) As best as you can know what type of dental care you or your family needs before buying a dental plan. Think of your current dental needs as well as an future dental care needs. If you have children try to get a dental plan that offer some coverages for orthodontic care if braces are ever needed in the future. Think about your over all healthcare issues that may effect your dental care needs. If you are a diabetic the gum care is very important and buying a dental plan that offer affordable deep cleanings will be very useful to you in maintain good gum health care.
8) Read, Ask and Know about the dental plan you may buy for yourself or your family. The better you understand the dental insurance plan and what it offers the better you can fit your dental care needs to your budget.