Dental Insurance policies help many people effectively budget for the cost of maintaining a great smile and good health.
Compared to medical insurance, understanding dental insurance policies is a breeze. Most policies are straightforward and specific regarding which procedures are covered.
If you’re wondering whether or not you need dental insurance, the first thing you should know is that medical insurance doesn’t cover most dental services. You can develop oral or dental issues at any time, either from not taking care of your teeth or as a result of an illness or accident.
Dental insurance provides you with coverage that can save you money and help ensure a healthy mouth. You’ll pay rates that dentists have agreed to accept for providing services to members. So whether you have coverage through your job or you purchase a plan on your own, dental insurance should be part of your financial planning for Medical Coverage.
Plans start for LESS than $1 a day.
Do you plan on your house burning down? Of course not, but you have insurance, just in case something bad happens.
Dental Insurance is purchased for the very same reason. You NEVER KNOW when something can happen that you will need this coverage, so do not hesitate in preparing yourself for any worse case scenario.
Dental procedures covered by insurance policies are typically grouped into three categories of coverage: preventive, basic, and major. Most dental plans cover 100% of Preventative Care, such as annual or semiannual office visits for cleaning, X-rays, exams and sealants.
Basic Procedures are treatments for gum disease, extractions and fillings, with deductibles, copays, and coinsurance determining the patient’s out-of-pocket expenses. Most policies cover a percentage or a flat rate (each policy is different) of these procedures, with patients paying the remainder.
Major Procedures typically include crowns, bridges, inlays, and dentures and are typically only covered at a certain percentage or a flat rate (each policy is different), with the patient paying more out-of-pocket expenses than for other procedures.
Time limit restrictions may apply.
Some dental plans only cover certain services, such as fillings or X-rays, a certain number of times a year or every few years. So, if you need a lot of dental work done up front, not all of the benefits may be covered immediately. If it’s urgent that you get the procedures and you can’t wait, you may have to pay out of pocket.
Every policy differs in terms of which procedures are categorized as preventive, basic, and major, so it is important to see what is covered when comparing policies. Some policies classify root canals as major procedures, while others treat them as basic procedures and cover much more of the cost.
The term "vision insurance" is commonly used to describe health and wellness plans designed to reduce your costs for routine preventive eye care (eye exams) and prescription eyewear (eyeglasses and contact lenses).
But unlike major medical insurance policies that may provide unlimited benefits after a certain co-pays and deductibles are met, most vision insurance plans are discount plans or wellness benefit plans that provide specific benefits and discounts for a nominal monthly premium (very affordable, usually a single digit premium). Most of the these plans can ONLY be purchased with the Dental Insurance NOT as a stand alone policy.
Vision plans generally cover or provide discounts on the following products and services:
* Annual eye examinations
* Eyeglass frames
* Eyeglass lenses (including lens coatings and enhancements)
* Contact lenses
* Discounted rates for LASIK and PRK (Depends on the plan)
It's always a good idea to ask the business staff at your eye doctor's office to advise you of the specific benefits of your vision plan prior to your exam and eyewear purchase so there are no surprises afterward.
Dental insurance plans tend to prioritize preventive dental care because of the important role it plays in overall oral health. Therefore, preventive dental services are often covered at 100 percent with minimal or no deductibles or co-pays (in other words, minimal out-of-pocket costs). In addition, with some plans, preventive services are not counted against your annual maximum.
List of "typical" Preventative Dental Services:
FYI - Actions include daily brushing with a fluoride-containing toothpaste, flossing, and maintaining a healthy diet – along with scheduling regular oral exams and professional cleanings.
In general, basic services are typically those types of treatments and procedures that are relatively straightforward in nature and don’t involve a significant laboratory expense for the dentist.
List of Basic Dental Services:
FYI –Just as prevention and early diagnosis are so important, so is correcting any problems that do develop as soon as possible.
A policy’s coverage for Basic services must be generous enough that when they’re needed they lie well within the member’s financial reach.
The Major dental services category typically includes procedures and treatments that are relatively more complex in nature and often involve a dental laboratory expense. These services tend to be more costly than those found in the Basic category.
List of Major Dental Services:
FYI –With some insurance policies, when it comes to providing coverage for Major services, you’ll find that their emphasis seems more geared toward preserving the status quo rather than providing for significant dental reconstruction.
It’s often the policy’s maximum policy limitations that becomes the problem. Its level is frequently high enough that one or two teeth can be rebuilt (root canals and crowns). But when major reconstruction is planned, this limitation is easily exceeded.
On a final note, don’t put off shopping for a dental insurance plan. As mentioned, most plans have a “waiting period” of up to a few months before coverage will officially kick in, so the sooner you purchase a policy, the sooner you can start using your dental benefits.
Ask about the Dental Plans with
NO DEDUCTIBLE and NO MAXIMUM on Annual Payout.
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