Whether you are purchasing dental insurance on your own or enrolling in a plan through your employer, consider these four questions to ensure that you get the coverage that you need.
What are the fees, co-pays and deductibles?
When you are thinking about purchasing dental insurance, cost is most likely one of your primary concerns. It is important to understand how much the insurance costs and what other charges you will be responsible for.
Many dental plans have a fee structure that includes co-pays and deductibles. For instance, you might be charged a $20 co-pay for each dental visit. The deductible is the amount that you must pay out of pocket before your dental insurance kicks in.
If you have any questions regarding the fee structure, make sure to gain clarification before you sign up for a plan so that you do not receive any unpleasant billing surprises. You can call your potential insurance provider or your Human Resources Representative at work.
Which providers are included?
Insurance providers cover dentist that are “in network” and “out of network” differently. Visits to dentists within your network will be cheaper than dentists out of your network. Some providers are not covered by insurance at all. Reading the provider list is another important part of choosing a dental insurance plan. If you already have a dental provider that you love, check to make sure that your provider will take your new dental insurance. You can typically find this information at the insurance website, by calling your dentist’s office, or calling your insurance provider.
What services are covered?
There is a wide variety of dental plans available, and each plan has different services that it covers. Most plans should cover dental maintenance visits, such as routine check-ups and cleanings. Additional dental emergencies and surgeries may not be covered. Think about the likelihood of needing emergency dental work in the future. If you or members of your family are prone to cavities, or worse, it will probably be worth paying a little more for little coverage. If you are confident that you will not need fillings or a root canal anytime soon, you may be okay paying a little less for insurance for not as much coverage.
Is it a PPO or HMO plan?
An HMO dental plan requires you to choose one dental provider and visit this provider for all services. If you need to see a dental specialist such as a periodontist or orthodontist, you are required to obtain a referral from your primary dentist and authorization from the insurance company. A PPO plan gives patients more freedom. If you have a PPO dental plan, you are free to see any of the dentists in your network without having to deal with referrals.
Getting answers to these questions will help you choose a dental plan that meets both your needs and your budget.
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