We all may be familiar with how traditional dental insurance plans work. You visit the dentist, had your dental card to the billing manage, the office submits the claim, the insurance company pays the office, and then you receive a bill for the uncovered balance.
Sometimes those uncovered amounts are quite large, which is why you might need a supplemental policy.
Most dental insurance plans will cover medically necessary procedures, the treatments that affect your teeth, and your gums’ long-term health and viability.
However, all bets are off when it comes to services that improve appearance only. You may have to purchase an optional rider or find a cross-over point.
Learn the secrets to success.
Not all dental insurance plans work the same way. PPO and EPO designs include a contracted amount that the provider agrees to accept as full payment for covered services.
If your provider charges more than what your plan approves or allows you could have reason to dispute the bill, or you may have to bite the bullet. Your fate depends on several factors.
Does it make sense to put your hard-earned dollars into dental insurance when the plans pay so little for expensive treatments such as root canals, implants, braces and other involved procedures?
You can lose sight of the big picture if you only focus on the limiting factors such as the annual maximum, copayments, and waiting periods. Hidden cost savings from network discounts, costs avoided, and tax savings tip the scales.
People with and without insurance often have to turn to finance to pay for routine and one-time dental procedures. Borrowing money from your dentist is not always the ideal alternative.
Besides, your local practice will probably refer your file to a third-party company anyway, which means choosing between a loan with fixed installments or a credit card with flexible payments.
People without insurance will often look for local dentists that accepts payment plans thinking that an office with in-house financing gives them an edge.
This approach rarely works.
Most dental practices partner with patient finance companies so they can focus on oral care, and leave the underwriting and collections activities to a third-party company.
Supplemental dental insurance when combined with flexible spending accounts does something magical. Patients with bad credit can finance their treatments without a need to pull their consumer report.
In addition, the two programs dramatically reduce the after tax cost of the work. It is like getting a below zero interest rate loan.
Patients can utilize supplemental dental insurance as a hidden form of financial assistance to help cover treatment expenses. The programs work well for those able to wait.
Tap into government grants that hide themselves in the form of tax-deductible expenses. Sometimes creativity counts.
Dental plans do not work like other types of insurance. Members are simply pre-paying for services and do not gain protections from unforeseen expensive hazards that could wipe you out financially.
Most plans have an annual maximum benefit or other cost-sharing feature that limits what the company pays. Patients are on the hook for the remainder. Find strategies to cope.
Dental insurance plans have limits. Sometimes they cap the benefits paid in a single calendar year, or pay only 50% of allowed charges for expensive major services such as oral surgery.
Health insurance will sometimes step in to save the day, when an operative procedure is medically necessary: the service treats an illness or injury to your mouth, jaw, or face.