The holidays are upon us and we have so much to be thankful here in Lynchburg. Health, family, fun, and of course our dental plans. I can guess what you are thinking right now, I just slipped in that “dental plan” in the midst of other holiday cliches. I did this for a number of reasons:
- There really is no exciting way to introduce a topic like understanding your dental plan on its own
- It is the end of the year and we want you to prepared for next year(which from what I see on the news could be a wild ride in the world of managed healthcare and dental plans as the country changes political direction)
So if you have made it this far I will outline some basic information about dental plans and some things you may not have considered..oh and while your here, happy holidays (in case I forget to say it at the end of this article:).
The Dental Plan Basics
Most dental plans fall into three general categories:
Employer: The employer covers part of the cost of basic dental services through a managed care group
Self: The individual has their own dental plan with a managed heath care plan
Add on: These are policies added on to an existing dental plan for specific things
For most of us we have our dental plan through our employer. Regardless of where, many do not understand their plan. More importantly they do not understand what is available to them. Here are some things to help you.
Classifying the Care
A good mental starting point with your dental insurance is to breakdown the classes of care benefits into categories. While very general, this gives you a framework to see what is likely to be covered completely or not. A simple breakdown of the three main classes of care include:
Samples: x rays,routine teeth cleaning
Samples: root canals, fillings
Naturally the preventative care is an essential level of care to understand. Many of these benefits are either covered completely or at least to a very high percentage of the total costs. These also involve basic dental health procedures that just about everyone needs to have done on a regular basis. Thus know the preventative benefits.
Know your plans Preventative maintenance benefits
Preventative maintenance includes things like biannual cleanings that are also very important to your dental health. It is important to make sure you are taking advantage of this. Many of these kind of serves are completely covered by your plan. This includes cleanings, exams and routine visits which are there to keep oral health problems from festering. This one area tends to also be pretty standard across many different types of plans, so look to this section as the foundation of your dental care coverage.
Basic Restorative and Major Services
As procedures get less generic and routine you move into the realm of restorative care and major services. Restorative care and major services are areas where some plans may cover a lot, if not all, of the available dental services. Likewise, with some plans, major services like cosmetic improvements may not be covered at all. Other things like dentures will usually have a deductible as part of basic restorative care. This will vary from plan to plan. This leads us to our next point.
Dental Plan Tips
Now that you have a basic understanding of the most common plans and care levels, here are some tips to help you navigate your dental coverage insurance experience:
Make Sure Your Family Is Covered
Check your plan to see that the entire family is on it. Do not assume their is coverage for your entire family just because you have it as an employee.
The Three Key Words To Look For In Your Dental Plan
Three key words you have to know to get the most out of your dental insurance:
Stay in Network
This just means you want to select your dentist from a choice that is mentioned in your dental plan as a preferred provider. You should have a booklet with all the dentists in the Lynchburg, Va area. If a dentist is not in your network, much, if not most, of the cost of visiting is not covered. I would not advise going out of network (instead of in network) unless you are in a position where it is critical to do so.
Overlooked Key Tip
Don’t hesitate to ask
You probably noticed that most, if not all procedures have a deductible. While free would be better, there are definitely discounts on both common procedures and more advanced ones. The key is to read the plan and review everything. You may need a cosmetic procedure and some of it could potentially covered.
Check,Check, and Double Check
If you are having any special procedures, or really anything, make sure your insurer will actually cover what they say. I would do this as much as you can, as so many managed health groups have stipulations for everything.
More Dental Tips From The American Dental Association
Here are a few more tips I saw online from the American Dental Association
Moving Forward in Lynchburg
If you need more information on your Lynchburg dental coverage contact us. We can walk you through your options and help you get the most from your plan.
…….Have a safe and happy holiday season!
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