All dental insurance is not created the same. Ruth and I met with several of her friends who were asking about dental insurance. Whether losing their dental insurance through their employer, needing a root canal or a crown replacement, or just having a check up when their budget was tight - they had questions. You may have them too.
There is no “enrollment period” for dental insurance. You may enroll or change companies anytime you want. Services may be different from plan to plan. Let’s talk about two typical comprehensive dental plans and some services you may want to compare. The deductible. Plan #1 has a $20 deductible while plan #2 has a $50 deductible. Comprehensive dental plans provide preventive services, minor/basic services and major/restorative services. Both of these plans pay 100% for two (2) cleanings a year and x-rays once a year, after the deductible has been met and assuming you go to a network provider. Network provider? Yes, ask your dentist’s office if they are in the dental plan’s network or ask the agent that’s helping you. If your dentist is not in the network, your benefits will be different. Minor/basic services are usually paid by the plan at 80% and you pay 20%. What is considered “minor/basic benefits”? Plan #1 covers fillings, root canals, oral surgery, periodontics and extractions. Plan #2 covers fillings and extractions. Major/restorative services are usually paid by the plan at 50% and you pay the other 50%. Services considered major/restorative in Plan #1 include crowns, bridges, implants, dentures, surgical periodontics and partials. Plan #2 includes crowns, bridges, dentures, root canals, periodontics, oral surgery, partials. Let’s look at this closer. Plan #1 covers some services at 80% (root canals for example) while Plan #2 covers those same services at 50%. How much will the insurance company pay on your behalf every year? Both of these plans will pay up to $1000 a year. What if you don’t use all of your yearly benefit? Plan #1 has a “rollover benefit”. If you have had at least one claim during the year and your total claims did not exceed $500, they will “rollover” $350 to the next year. The second year your benefit would be $1350 ($1000 + $350 rollover). They will continue to “rollover” $350 every year you qualify until your total benefit is $2000. Plan #2 does not have a “rollover benefit”. How long do you have to wait before you can use it? Preventive services are provided by both plans immediately. Minor/basic services are provided by both plans after 6 months. Major services are provided by Plan #1 after 6 months and Plan #2 after 12 months. If you have current dental insurance, you may be able to waive this waiting period – ask about those details. Want to talk about your dental issues? Call me at 501-868-6650 and say “Caroline, can we talk?”
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AuthorCaroline Beauchamp specializes in personalized life and health insurance solutions. Archives
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