Dental insurance can be confusing and intimidating. There’s so much to know and understand. Add to that the fact that most insurance companies are only open during business hours and it makes contact them for answers even more difficult.
We interact with patients on a daily basis who have questions about their insurance benefits. Here are some of the most common questions we get and see people in need of answers for.
What is the difference between my dental and medical insurance?
Dental insurance was designed to cover preventative treatment like cleanings, x-rays, and fluoride treatments. They also cover restorative treatments like fillings and scaling and root planing for periodontal disease treatment.
The percent your insurance covers will depend on your actual plan, which is why it is important to give them a call and fully understand what is covered and what is not.
Medical insurance differs from dental insurance in that it covers both preventative care and treatment of ailments that impact pretty much everything but the mouth. Although, many medical insurances will cover traumas to the mouth. Contact your medical insurance company so you have a clear idea of what you’re covered for.
Orthodontic Care Is Often Not Covered
Dental plans don’t typically cover orthodontic care unless it is deemed medically necessary for your mouth to function. This means that if your child has crooked teeth and you fear for them being made fun of, you more than likely will have to cover the cost of braces out of pocket.
With that in mind, we offer several payment options to families who might not want to pay for their dental treatment all up front. This includes Care Credit and payment plans.
HMO vs. PPO
Just like in health insurance the dental insurance work has PPOs and HMOs. HMOs limit who you can see to dentists within the insurance’s network, but the cost is overall lower. This makes them a great option for individuals who might require more dental care than others.
PPOs give you more freedom to choose a dentist, but are more expensive and often cost more for people who need more than the typical dental cleaning or filling each year.
Look for a Dental Discount Plan
Dental discount plans are incredibly helpful at lowering the cost of dental care up to 60%. These are not insurance plans and are not regulated, but they work to negotiate the cost of a procedure with a dentist for those on the plan. Oftentimes procedures like fillings and cleanings are less than $10 or $20.
As a patient you have a right to understand up from what the cost of a procedure is going to cost. As the dentist before the procedure is consented to so you have the option to call other dentists and shop around. This is no different than looking for a better deal on a prescription drug or asking your doctor for an upfront list of charges.