3 Tips To Get The Most From Your Dental Insurance | Espinal & Willis

Understanding the benefits from your dental insurance can assist you in your quest for strong teeth and a healthy mouth. The three tips below are designed to help you get the most out of your dental insurance benefits.

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1. Understand Your Coverage

Deductible – this is the amount you are required to pay before the dental insurance begins to pay their portion. For example, an individual may have a $50 deductible, this $50 must be met before the plan begins paying benefits. However, some insurance plans do not require the deductible be met before dental cleanings. Many dental plans cover these biannual cleanings at 100 percent.

Maximum – this refers to the maximum amount of money that the insurance will pay for dental services within a specific amount of time (usually 12 months). Depending on the plan, this maximum can be for an entire family or one individual. Annual maximums are typically between $1,000 and $2,000. For major restorative work, $1,000 can add up quickly, so be sure to track the cost of all dental treatment throughout the year.

Tip:

If you have extensive treatment that will exceed your annual maximum, ask your dentist if any of the treatment can be carried over to the new year when your maximum resets.

2. Ask for a Pre-Determination

Once treatment is recommended by your dentist, you have some time (unless it’s an emergency) until the treatment is actually completed. During this period your insurance can give you an exact cost for the treatment by having your dental provider send a pre-determination to the insurance company. This can take up to a few weeks, but you have the comfort of knowing exactly what your out of pocket cost will be.

3. Always check your E.O.B. (Explanation of Benefits)

The insurance company provides the patients with a summary of the services rendered and the payments made by the insurance company. This summary is referred to as an Explanation of Benefits (EOB). This summary also shows the patient’s responsibility. Patients need to read their EOBs thoroughly: If there are any questions or discrepancies, the insurance provider or dental office should be contacted.

Conclusion:

Studies indicate a solid connection between an individual’s oral health and his or her overall health. Most plans cover biannual dental cleanings so be sure to visit your dentist twice a year to get the most from your dental insurance. Use it or lose it!