We’re almost in the second half of November and you only have six weeks to make the most out of your dental benefits. Now that dental practices reopened its doors, it’s time to tackle your postponed dental treatments after several months of quarantine. Let’s get into details about your dental benefits and how much you should prepare for possible out-of-pocket costs.
Dental benefits help you lessen the financial burden of keeping your oral health in good shape. It can be provided by your employer along with your medical benefits or you can enroll yourself for a stand-alone policy. Most dental benefits only last until December 31 and usually have an annual maximum of $750 to $2000.
The dental services covered by most dental benefits provider include:
Most dental insurance companies don’t cover cosmetic dental services. Some of them cover braces treatment under the major treatment category, but oftentimes, other insurance providers consider it as a cosmetic treatment.
There are two major differences that you will notice between dental benefits providers. First, they have their own way of categorizing dental treatments. Second, they can set a different coverage structure and frequency limitation for every dental service.
Here’s how most dental benefits providers classify dental treatments:
Dental treatments under preventive care are at 100% coverage but these include frequency limitations and copays. Oral exams, x-rays, and cleaning are the services under this category.
Root canal, simple tooth extractions, and gum disease treatments are under the basic category and covered by most dental benefits providers at 60% to 80%.
Complex dental treatment falls under the major category with 50% coverage. These include oral surgery, crowns, bridges, and dentures.
Copay is a dollar amount that you need to pay during your dental procedure, even if the treatment is covered in full. Coinsurance is the percentage that you have to pay after your coverage was deducted. Lastly, a deductible is an amount that your treatment cost should meet for the coverage to kick in.
There’s a possible way for working couples, who both have employer-provided dental benefits, to reduce or not pay any out-of-pocket dental costs. Your dental benefit plan in your company is your primary plan. If you’re enrolled by your spouse as dependent on his/her dental benefits plan, it becomes your secondary or supplementary plan.
Now, if the coverage of your primary plan for a specific dental treatment is higher than the second plan, you will not get any deductions from your secondary plan. However, if your secondary plan has a higher coverage for a specific treatment than your primary plan, it can reduce or shoulder your out-of-pocket expenses.
Having two dental benefits or dual coverage has limits based on the insurance policies of your insurance providers as a couple. You can spend less on paying for a supplementary plan than insurance premiums, as long as your dental benefits providers don’t have a non-duplication of benefits rule.
Don’t just count the days and lose your chance of paying less for dental costs. Dr. Roy Jennings Dentistry provides comprehensive dental treatments in Monroe in partnership with the following insurance providers: