Want to get the most out of your dental coverage? When you review your coverage, ask these key questions to increase your dental plan IQ.
Dental plans have networks of dentists who have agreed to charge less than their normal fees to people covered under the plan. That’s why you get greater savings when you visit an in-network dentist.
It’s important to choose a dental plan with a large network of dentists. For instance, 3 out of 4 dentists nationwide participate in the largest Delta Dental network. This makes it easy to find a dentist that participates in the network. In fact, your current dentist may already be in-network.
If you choose to visit a dentist that is out-of-network, covered services might be reduced and/or your out-of-pocket costs might be higher. Check your plan to see if it requires that you visit an in-network dentist, so you know what limitations may exist.
When comparing plans, in addition to the premium, be sure to consider these details:
• What is the deductible for the plan? This is the amount you pay out-of-pocket for treatment before the plan begins to pay. There is usually not a deductible for preventive and diagnostic services like exams, cleanings and X-rays.
• What are the co-payments or co-insurance for various treatments? These costs represent the set fee or percentage of procedure costs you’ll share with the plan.
• What is the annual maximum the plan will pay? If you expect to need several expensive dental treatments in the year ahead (i.e., crowns, bridges, root canals, surgeries), you may want to look for a plan with a higher annual maximum. You can also talk to your dentist about spreading your treatment over two or more years, as many dental treatments are elective.
Because it varies from plan to plan, check to see if certain procedures are covered if you think you or your family may need them in the near future. For instance, not all plans cover:
• Teeth whitening and other cosmetic procedures
• Braces and other orthodontia
• Pre-existing conditions like teeth that were missing before you joined your plan
Some plans also have a waiting period — a certain amount of time you must be in the plan before all or certain dental procedures are covered. There may also be frequency limitations, such as no more than two cleanings or exams in a 12-month period.