With terms like PPO, HMO, in-network, and out-of-network to describe dental benefits, it's no surprise that many don't understand how to make the most of their plan. This means you may be overlooking benefits that are critical to maintaining your oral health.
Don't settle for just what you understand as part of your coverage. Read on for 5 simple tips to take advantage of everything your plan has to offer.
The best way to take advantage of your plan is to ensure you know the type of plan it is and its deductibles, copayments and annual maximums.
There are two main types of dental plans:
Key things to understand about your plan are its:
In addition to understanding the basics of your plan, it is important to explore all of the associated benefits.
Most individuals are aware of and will use preventive services for professional cleanings every 6 months. These services are often covered in full by HMO plans and between 80& and 100% by PPO plans.
However, there are other benefits that should be included both in your plan booklet and online. Thee benefits may cover restorative care (like fillings), major restorative care (like crowns and bridges), as well as orthodontic care. By doing your research, you can determine what procedures are covered, what limitations each procedure has, and if there are any exclusions.
One of the most significant challenges for many individuals is determining whether or not a dentist is in their network. This can be particularly difficult for plans that have multiple networks because dentists may participate in all or some of them.
If you choose a dentist that is out of your network, the amount of insurance coverage you receive for your treatments will vary. As such, seeing an in network dentist allows you to maximize your benefits.
Coverage will differ if you go out of network
on either type of dental plan:
To maximize your benefits, it is best to schedule treatments in advance to align with your annual maximum. In many cases, you can strategically plan multi-stage treatments with your dental professional to minimize your costs as much as possible. Of course, it is also important to be prepared for unforseen dental emergencies.
Track claims as you receive treamtent, so you are aware of when you are approaching your annual maximum. After each appointment, review your treatment summery to see what your carrier covered. Then subtract this amount from your annual maximum to calculate your remaining coverage foe the given benefit period.
You sign up for dental insurance for the benefits and you should receive what you paid for. By utilizing each of the tips above, you can make the most of all your benefits and keep your smile looking great.
10 Tips to Maximize Dental Benefits. (2014, February 14). Retrieved July 2, 2015 from https://www.dentalinsurance.com/blog/?post_type=resources&p=1554
Maximizing a dental benefits plan: 6 easy tips. (n.d.). Retrieved July 2, 2015, from https://www.deltadentalins.com/administrators/guidance/maximizing-a-dental-benefits-plan.html