When I asked friends and family things they would like to know about dental insurance, most said the same thing, “Why doesn’t my insurance cover _____”. The thing to remember about your insurance is that it is meant to help offset the cost of dental care. Very few dental plans cover everything 100%. Keep in mind that insurance companies are a business, they want to make money. So if you pay into a dental plan each month but rarely use your benefits then they are making money. What I tell friends and family is at the very least get in twice per year for your cleanings, exams & x-rays. Most plans cover those service 100%.The best advice I can offer for not wasting money is to have a better understanding of what your plan covers and if it has any limitations. Know if your plan is a calendar year (Jan – Dec) or if it is a plan year (year to year from when you signed up.)
If you are on a calendar year plan and need any dental treatment, the end of the year is fast approaching. Remember that any of the yearly maximum that is not used is lost, and starts over in January of the next year.
If you are in the market for new dental insurance, here is some important information to ask:
“Does the plan have any waiting periods?” – Some plans have six month to one year waiting periods for certain procedures such as crowns, bridges and implants. So be aware of that beforehand just in case you need those types of treatment.
“Does the plan have a missing tooth clause?” – What this means is if you are missing a tooth prior to obtaining coverage, they will not pay to replace the missing tooth with a bridge, iImplant, or partial denture (removable bridge.)
“Does the plan require you to go only to a certain list of doctors?” - Some of the new plans available require you to go to specific clinics such as Brite Smile & Sunrise Dental. We are preferred providers for the following insurance companies: Delta Dental, Regence, Premera, Cigna, Principal Financial, Watchtower, GEHA. We are also in the process of contracting with Metlife, Aetna and United Healthcare.
“Are the dental plans available on the health exchange accepted everywhere?” – Unfortunately no, most of these plans require doctors to sign separate contracts to accept the plans.
We are always happy to answer questions about your dental plan, please let us know if we can be of assistance.