Understanding Dental Insurance – Ormond Beach, FL
Are You Taking Full Advantage of Your Plan?
Dental insurance can be difficult for some people to understand, and there are a lot of misconceptions that can lead to patients accidentally leaving dental dollars on the table instead of using their benefits to maximum effect. Our team at Brown & Nawrocki Restorative & Cosmetic Dentistry wants you to take full control of your dental care, and understanding your insurance is an important part of that. Below are some important tips about your dental insurance plan that you should always keep in mind. Call us if you have any additional questions.
How Does Insurance Work?
Dental insurance provides coverage for a variety of dental services in exchange for the payment of monthly premiums. Most plans are structured to fully or mostly cover preventive services while paying 50% to 80% of the cost of restorative dental services, with basic services usually receiving higher coverage. The idea behind this structure is that it rewards patients who seek the care they need to prevent dental problems or to have them treated as early as possible instead of waiting for something to go wrong. Every plan is slightly different, so check with your insurance company if you don’t know for sure what’s covered and what’s not.
“Out of Network” Does Not Mean “Out of Coverage”
You might see the terms “in-network” and “out-of-network” thrown around when looking for local practices that take your dental insurance. Remember that “out-of-network” does not mean that the practice won’t take your plan. “In-network” simply means that the dental practice has reached an agreement with the insurance company about what rates they charge for certain services. With an out of network provider, you may not get the same percentage of coverage, but you can still receive coverage nonetheless. Our practice is more than happy to accept a variety of plans.
Don’t Let Insurance Pick Your Provider for You
While your dental insurance may push for in-network providers, the final decision always comes down to you. Don’t let the insurance plan you have be the sole factor in deciding whether a practice is right for you. When it comes to dental care, oftentimes you get what you pay for. Think about the quality of the care that your dentist offers and think carefully about whether it’s worth the additional price. Note that in some cases, there’s very little if any difference between what your insurance company covers in and out of network.
Make Sure You Know Your Plan
Dental insurance plans vary from person to person. To understand your specific benefits, you need to take the time to review your own plan. Remember that the percentage that your insurance company pays your dentist is based on a “set allowable amount”; in other words, the insurance company has set a price level for each treatment that it’s willing to pay for, and you need to understand these set prices so that you know how much you can expect to pay out of pocket. Also, most of the time dental insurance has an annual maximum that puts a limit on how much your insurance company will pay for dental care during a given year. Be aware of this amount when planning any sort of treatment.