Dental insurance is a helpful tool that allows patients to receive more affordable dental care. However, since it works quite a bit differently than dental insurance, many people have difficulty navigating it and maximizing their benefits. Fortunately, your dentist is here to help you gain a better understanding. Continue reading to learn some tips that will help you best comprehend how your dental insurance plan works.
Choose Your Own Provider
If you have a preferred provider organization (PPO) plan, this means that instead of your insurance company dictating who you can see for dental care, you get to decide. However, it is still important that you check to see the differences in covered between dental providers so that you aren’t surprised with a bill that is larger than what you were expecting. By weighing the pros and cons, you can determine who is best suited for your dental care needs.
Understand the Meaning of “Out-of-Network”
You may think that out-of-network means that you are completely out of luck when it comes to that dental provider, but this is not necessarily the case. While in some situations you may not receive coverage for treatments at that practice, other times this just means that the amount that is covered reduces. Coverage is still available to help you receive care a lot of the time.
Know Your Individual Plan
Your dental insurance plan is unique to you. When you understand exactly what it covers, you will feel more confident to seek the care that you need and want. Your insurance company pays a percentage that is based on the price level set for each treatment whenever you go into the dental office. You should know what this allowable amount is before committing to treatments so that you know exactly what you will be responsible for afterwards.
Understand That You Are the Customer
Your dental provider is not the customer of your insurance company – you are! If you find yourself in a situation where you need to pay your provider in full, your insurance company will reimburse your directly in just a matter of weeks. They are much faster to reimburse you than the practice. Your dental administrative team is happy to help you get this all worked out, but it is always a good idea to verify your benefits yourself.
Let’s face it – dental insurance can be quite confusing if you aren’t familiar with it. By taking time to understand it better, you will be have an easier tie maximizing your benefits and get the essential care you and your family need.
About the Author
Dr. Gary Chaffee is an experienced dentist who has been practicing for more than four decades! He graduated from Loma Linda University School of Dentistry and is currently a member of numerous professional organizations including the American Dental Association and the California Dental Association. His practice is a preferred provider of Amgen and other insurance companies in Ventura county, but they also accent numerous other insurance plans. For more information or to schedule an appointment with Dr. Chaffee at his practice in Thousand Oaks, visit his website or call (805) 480-0033.