Dental Insurance for Dummies - Dynamic Dental [PDF]

Dec 9, 2010 - When your medical or dental insurance sends you an explanation of benefits (EOB) in the mail, do you throw

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Dental Insurance for Dummies Author: Jeff Salmeri Dec 9, 2010 8:47:00 AM

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When your medical or dental insurance sends you an explanation of benefits (EOB) in the mail, do you

SUBSCRIBE

Insura

throw it unopened on a pile of paperwork that includes the deferment paperwork for your student loans for-

from 1962? Or are you thinking "What the heck is an explanation of benefits?" If you do open it, does it Dumm

CATEGORIES

hit you like a Rorschach Inkblot test? You think there is something important you are supposed to be able Dental Health and Wellness (33) (//www.dynamicdentalinc.com/blog/topic/dental-health-

to see, but you can't quite figure it out. When you ask your HR person at work to explain the basics of

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the group dental plan does he or she say "It covers some stuff" or "We have a group dental plan?"

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and-wellness)

Compared to your medical plan, your group

General and Family Dentistry (15)

dental plan is a cinch. Here is what you need to

(//www.dynamicdentalinc.com/blog/topic/general-and-

know:

family-dentistry)

1) Deductible - Typically $25 or $50. This is

Cosmetic Dentistry (11)

Insura for-

Dumm

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applied and paid by you when you have your first mini=t

(//www.dynamicdentalinc.com/blog/topic/cosmeticdentistry)

appointment for dental treatment like a filling or Insura crown. Most plans do not apply this deductible for-

Teeth Whitening (8)

toward your exams and cleanings, therefore no Dumm money is due from you during these types of

(//www.dynamicdentalinc.com/blog/topic/teethappointments.

whitening)

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2) An annual maximum benefit - This is typically $1000.00 - $1500.00. Most plans are calendar year. url=ht Insura When the insurance has paid benefits up to this amount you are cut off until next plan year. On January for1st of the next year your maximum is available to you again. Dumm

Dental Implants (6) (//www.dynamicdentalinc.com/blog/topic/dentalimplants) Modern Dentistry (5)

3) The annual maximum benefit is paid out in percentages depending on the type of service you

(//www.dynamicdentalinc.com/blog/topic/modern-

have at the dentist. Typically:

dentistry)

Type 1 services (Preventative) 100% coverage - exams, x-rays and cleanings, fluoride and sealants for

Pediatric Dentistry (5)

kids up to a certain age.

(//www.dynamicdentalinc.com/blog/topic/pediatric-

Type 2 services (Basic restorative) 80% coverage - fillings, root canals, extractions, periodontal scaling

dentistry)

and root planning (deep cleanings).

Dental Insurance (2)

Type 3 services ( Major restorative) 50% coverage - crowns, build ups, posts, dentures, bridge work.

(//www.dynamicdentalinc.com/blog/topic/dentalinsurance)

So know you know the basics! Easy right? That's what Mrs. Hellgren said back in '75 in grammar class.

Facial Rejuvenation (1)

Then she uttered the mind wrenching word "Exceptions". "I before E except after C" The hell had

(//www.dynamicdentalinc.com/blog/topic/facial-

begun. (Is that an incomplete sentence?) Anyway....

rejuvenation)

The biggest pit falls to look for in your group plan are the following "exceptions":

Comments

WAITING PERIODS: Woops! You have to wait 6 months from your effective date on the group dental plan for Type 2 services to be covered! MISSING TOOTH CLAUSE: If the tooth was missing prior to your effective date with the group plan, too

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bad. They are not going to pay to replace it with a bridge or implant.

An experienced dental receptionist will have knowledge

FREQUENCYS: The group plan allows certain services at certain intervals. Cleanings every 6 month plus

of these basics and be able to give you a pretty

1 day. (I'm not kidding, have your cleaning 1 day too soon and you insurance won’t cover it.) Full sets of

accurate estimate before the treatment is

x-rays are usually limited to every 3-5 years. That means if you switch dentists you want to have those x-

performed.Yes absolutely true!

rays sent over before you arrive. Now that you know the basics, how do your maximize your benefits? Most importantly, GO TO YOUR

Zahnarzt Münster (http://zahnaerztemuenster.com/)

DENTIST! "Use it or lose it!" I guess what I am trying to say is that your group plan is like someone

Dental insurance should be affordable so many people

saying they will pay a percentage of your bar tab. How often does that happen? So find out what your

can benefit. Especially the poor and less fortunate one.

plan covers and use it to the maximum. Insurance companies love it when you pay your premium and then NOONE uses the insurance! I love dental insurance. It facilitates oral health and helps people who could absolutely NOT afford a check up and cleaning, get one for free! Make sure you go to a dentist who is actually CONTRACTED with your group plans insurance company. They are contracted to only charge you the agreed upon fee schedule and collect only your portion for covered services. Another cool feature is that your friendly dental receptionist can send a PRE-TREATMENT Estimate to your plan for the work you need. The insurance company knows it is for work that MAY be performed, but has not yet been done. That way you see ahead of time exactly how much they will pay. An experienced dental receptionist will have knowledge of these basics and be able to give you a pretty accurate estimate before the treatment is performed. In review: Maximums, deductibles, percentages, bring chocolates to your dental receptionist, and watch for exceptions! http://www.dentalinsurancezone.com/ (http://www.dentalinsurancezone.com/) Posted in:

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