Dr. E recognizes that dental insurance can be tricky business. Is a dental insurance plan worth the cost? Which dental plans are widely accepted and which ones carry the lowest rates? Here are some tips to consider before choosing the right dental plan for you and your family:
Dental Plan 101
Chances are, you’ve heard the phrase“100-80-50” coverage, meaning the dental plan pays 100 percent of the cost of checkups, cleanings and routine care; 80 percent for fillings, root canals and other common procedures; and 50 percent for major procedures.
But NOT all plans are created equally. There are THREE main types of dental insurance you need to be aware of – the Health Maintenance Organization (HMO), the Preferred Provider Organization (PPO), and, finally, indemnity plans.
In a nutshell, HMOs only cover services for dentists within a limited network. (Hint… if you’re not sure if Dr. E is in-network for your plan, call the office today to find out!) PPOs offer patients a bit more leeway than HMOs. Patients gain the option to see dentists outside of their preferred network, for a higher price, with reduced rates applied toward in-network dentists selected by patients. Alternatively, indemnity plans give patients the opportunity to pay a deductible in order to gain the freedom to see any dentist they wish. The plan then picks up a pre-set percentage of costs for various dental procedures. This additional freedom typically comes at a higher cost to patients, with indemnity plans being the priciest option of the three types of plans.
Common Plan Pitfalls
Once they “land” with a plan, some patients are unfortunately left feeling like they bit off more than they can chew. Remember, no two plans are the same, with each dental plan carrying its own set of parameters. Some plans require waiting periods of up to six months (or more!), which means patients experience a long delay between enrollment and their actual coverage kicking in. Clauses can also be problematic. For example, if you had a tooth extracted before your new policy became effective — surprise — the replacement procedure might not be covered due to a missing tooth clause. Did you miss the boat with braces in middle school only to find yourself ready for braces as an adult? Too bad — many plans do not cover adult orthodontic treatment. On a similar note, are you finally ready to perfect your smile with a cosmetic procedure? Beware! Cosmetic procedures are rarely covered by most major dental insurance plans. Always, always, always, read the fine print in order to clearly understand your plan coverage and restrictions. Avoid sticker shock by knowing your yearly maximum and deductible amounts and which major services are covered for you and your family.
Consider a Dental Savings Plan
While some patients opt to pay for traditional dental insurance plans in order to gain peace of mind – they know they will have access to the services they need at any given time — others seeking more affordability and flexibility go with alternative options, such as a dental savings plan.
With dental savings plans, discounts are applied to dental care costs, there are no dreaded waiting periods or annual caps, and patients don’t face restrictions due to preexisting conditions. Many reputable dentists (Dr. Janet Euzarraga included!), offer dental savings plans to cater to the individual needs and budgets of their patient base.
Parting Thoughts on Dental Plans
Dr. E knows firsthand that all dental plans are not created equally. She finds that most of the Delta Dental plans provide fairly comprehensive coverage while Cigna’s low contracted rates really benefit patients when it comes to paying out-of-pocket for procedures. With a plethora of options in play and varying individual needs, Dr. E encourages patients to discuss their needs with her in order to determine the extent of their treatment plan. The GOOD news for Dr. E’s patients is that she is considered in-network by most PPO plans AND she offers an In-Office Savings Plan for those patients with no dental insurance.
The most important take-away here is that just as there is no “one-size-fits-all” approach to your dental care, the same applies to your dental insurance plan. That’s why Dr. E’s Cosmetic & Family Dentistry is committed to putting the patient’s needs first by identifying a payment solution that works for them. Contact our office today to discuss your options: 480-494-2435.