There are a variety of methods to access and pay for dental care. Coverage can be included as part of an employer’s benefit package, through an individual dental policy, accessed through a discount plan offered directly from the provider, or just by paying out-of-pocket for everything. Statistics show that a person is more likely to have regular checkups for their teeth if they have insurance that helps cover the cost. They are less likely to go if they are concerned about having a sizeable bill to pay.
When evaluating a dental plan, find out the value of the benefits you will receive in order to compare them to the premium you will pay. For dental plans, you should expect to pay a premium that covers the value of preventive care plus a stated coverage benefit for other services that you might need. For example, if your dentist charges $250 for a cleaning and exam and you budget for two cleanings annually, the $500 expense would be covered if your monthly premium is roughly $41.50/month. If you have any further dental work done during the year, plans typically cover a set percentage of the charge up to a maximum amount. These extra charges and discounts increase the value of your plan.
There are many dental plans and each company uses a network of dentists who have agreed to accept payment from these carriers. Most plans will base their coverage on the “usual and customary” rates for dental procedures. For example, if your plan states it will pay 50% of the charge for a filling or simple extraction and your dentist charges $400 for the service, there is a discrepancy between the billed amount of $400 and the “usual and customary” rate the insurance company will cover. If the “usual and customary” charge is only $200, the plan would likely only pay $100 (50%) of your expense and the remaining balance above the $200 would be your responsibility.
If you need help sorting through your dental insurance options, the licensed agents at On Point Health Insurance Agency offer help advising and enrolling in dental plans for individuals, families and seniors. They are your trusted and local resource for health insurance advice.
For more information: www.insuranceonpoint.com or call 402.625.6578 to connect with a local agent.