September is a good time to start researching your dental insurance options.
As a private practice, Floss is contracted with many dental insurance companies. Dental insurance can be very confusing if you do not have the proper information to make the best selection for you and your family. In this article, we discuss dental insurance with and without waiting periods, what questions you should be asking when shopping for dental insurance, PPO vs. DMO, and health savings accounts.
What should people understand about dental insurance without waiting periods?
Dental insurance without waiting periods is a huge advantage for patients. Usually if there is a waiting period (which is rare) it is six months to a year. Without any waiting period you can get procedures completed before things progress and get worse.
Insurance companies will only pay a percentage of your dental fees. If you choose an in-network provider, then that provider has agreed to bill a certain discounted fee for each procedure as contracted with the insurance company. This is a huge advantage for you, the patient! Some procedures may not be covered at all whether in or out of network. Your dentist can always send a preauthorization to your insurance to find out how much the insurance company will pay on a diagnosed treatment. Once your annual max has been reached within a benefit year, the insurance company will not pay anything more which leaves you, the patient, responsible for any further billing.
What questions should people ask when buying dental insurance?
- What is the monthly premium?
- What is the annual maximum?
- What is the annual deductible?
- Is my dentist in-network?
- Are preventative and diagnostic procedures covered at 100 percent? If not, what percentage are they covered?
- At what percentage are basic and major procedures covered?
Asking these questions when enrolling with a plan will help you, as a patient, to get the best benefit for your dental needs without paying for something you cannot use.
If you don't have dental insurance and need dental care, what's the best way to approach finding coverage?
Call your dentist to find out what insurance plans they are contracted with. Then call some of those insurances to find out premiums, maximums, and coverage percentages. Always ask if the policy is a PPO or DMO. For a DMO policy, there is a list of only certain providers and if you do not go to a dentist listed, the insurance company will pay nothing. DMOs May be less expensive, but you are much more limited on your selection of dentists.
Also, always ask your dentist if they have an ‘in-house plan’ for their patients without insurance. Floss has a great program that provides you with discounts for services, and also offers cash discounts.
Are dental savings plans a worthwhile option?
There is a pretty large difference between dental savings plans and health savings plans:
Dental savings plans are provider specific. Each individual dental office decides whether or not they accept these plans. Dental savings plans are not always attractive for the practice because the agreed upon fees for the services are so low. Therefore, your dental office options are often quite limited.
Health savings plans are a great benefit for employees if your company contributes fully or matches the annual amount. The money is always pre-tax and can be used for any medical or dental procedures. Keep in mind that many of these plans do not roll over into the next year, so they must be used before December 31, or the money is lost.
When is the best time to be thinking about insurance?
Open enrollment for insurance coverage runs from November 1 – December 15 for 2021 coverage. You can enroll in a medical plan that includes dental, or you can opt for a stand-alone dental plan. Early fall is the best time to research the plans and options so that you are not in a scramble during the open enrollment period. If you have insurance through your employer, the start date of that coverage can vary from day one to 90 days from the start of employment. Make sure you understand your benefits no matter your insurance situation so that you can take the maximum advantage of your benefits to ensure a healthy smile.