Dental Insurance Coverage - 5 Things You Must Know
By David
M Siegel
You need to know you as much about your actual coverage as possible.
You see Blue/Cross, Aetna and all the others sell a huge variety
of coverages. So it is not enough to know you have, say a Cigna
PPO. You need to know (and make sure your dentist knows) ALL the
specifics of YOUR Company's coverage.
A dental office that works effectively with insurance will verify
your benefits IN DETAIL before any treatment is recommended or
started. We actually ask nearly 70 different questions of the insurance
company representative for each patient we see!
Co-pays and deductibles mustn't stop you from getting treated.
As I mentioned, the insurance companies use co-pays and deductibles
as ways of preventing you from getting treatment. They hope you'll
decide a $50 deductible is too much to pay and you won't use the
insurance. If you find cash tight, find a dentist that can make
treatment affordable.
If you need the work, DON'T LEAVE UNUSED
INSURANCE AT THE END OF THE YEAR! This is a big deal. Patients
will suddenly decide they are going to get their dental work
done after years of putting it off. Often they decide as part
of a New Year's resolution. They just lost thousands of dollars!
Why? Because MOST insurance programs run on a calendar year.
So on December 31st whatever insurance you didn't use for the
year "disappears!" That's money you just
lost.
If you need dental treatment that will use up all of your insurance
for the year -- Have your dentist make plan to spread out treatment
over 2 years worth of coverage. Particularly in the fall this is
a great thing to do. If your insurance runs on a calendar year
you have the remaining unused insurance from the current year and
within months you have a whole new years worth of insurance to
use to continue treatment. We do this routinely!
Make sure whatever your Dentist is recommending
is actually covered by your insurance. There are exclusions,
pre-existing condition clauses, "Least expensive alternative treatment" clauses and a
host of things the insurers use to lower the chances of you using
the insurance for "top notch" types of treatment. If you want an
implant instead of a partial denture that you have to take in and
out every day, you need to know if your insurance will cover the
more expensive treatment. (NOT LIKELY)
If you have a missing tooth and think you might need another one
out soon, get the missing tooth replaced BEFORE you take out the
other. The reason is, most insurance companies, if they see two
or more teeth missing in one arch they will only pay for the cheapest
fix (removable partial dentures). If only one tooth is missing
even the insurance companies can't limit you to that single option
(most of the time).
If you follow these five rules you should
be able to effectively use the benefits available to you. No
matter what, if you don't go to the dentist and get treated you
will lose thousands of dollars of insurance. You have only benefited
the fat cat insurance executive and shorted yourself. It may
not be fun but dental care is necessary. Get what's owed to you & invest
in and improve your health.
