Is Dental Insurance Worth The Monthly Premiums?

You might be aware that health insurance sometimes covers dental work when medically necessary, care arising from non-biting accidents, certain diseases, and treatments considered integral to other services included in the plan.

Finding a dentist that accepts your medical insurance is not the most significant challenge if you do not have dental insurance. Getting the claim paid matters far more.

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.

Your insurance will not honor claims for corrective jaw surgery unless the orthodontist and oral surgeon convince the issuing company that the procedure is medically necessary.

The oral surgeon should submit a letter to your health insurance before performing the orthognathic surgery.

The orthodontists should submit a letter to your dental insurance to cover the braces needed before and after the surgeon corrects your jaw alignment issues.

Medicaid provides free dental insurance to low-income children throughout the country and often (not always) extends these benefits to adults over 21, disabled individuals, pregnant women, and seniors dual-eligible with Medicare.

However, the coverage is not uniform, as each state decides whether to support benefits for dental work and which services to include or exclude.

Seniors and adults with disabilities rely on Medicare to address their health needs. However, the government benefit does not cover dental work by design.

Meanwhile, oral surgeons perform medical and dental procedures billing both types of insurance, so it is natural to ask which operations Medicare Part B or Advantage plans might cover.

Learn how a letter of medical necessity is critical to getting the benefits you need.

People with dental insurance often learn the hard way that their plan will deny many claims because the contract contains a long list of exclusions, and sometimes procedures are deemed unnecessary.

The correct course of action after your dental plan denies your claim depends on the reason. Most times, your options are limited because your premiums fund preventive rather than restorative care.

Dental insurance is a misleading term because these plans promote preventive services to help patients maintain good oral health. However, their value quickly fades when you need expensive treatment.

The maximum annual benefit means that patients will have to pay most expenses out-of-pocket because the average limit of $1,500 does not stretch very far. Find ways to cope once you reach to cap.