If you are lucky
enough to have dental insurance there are several things you should know. The
average person though is not informed enough about the basics of their
insurance.
There are several
basic facts your need to know:
·
Your insurance plan is
a contract between your employer (unless it is strictly a personal plan) and
the insurance company
·
Dental insurance isn’t
true insurance. It was invented 50 years ago to help insurance companies sell
their other plans. Unlike renters/owner, auto, and health which pay out when
you have a problem, dental insurance is preventive in nature
·
Most plans have not
changed in the last 50 years and you still just get about a $1000.00 a year.
Taking into account just basic inflation plans worth $1000.00 fifty years ago
should be worth over $7500.00 today
Unless you work for an
insurance company, you probably do not spend a lot of your time studying all
the terminology that dental insurance companies use to describe the treatments
and services they cover. If it seems pretty confusing, here are some of the
most commonly used dental insurance terms and what they mean.
Basic
Insurance Terms
Annual
Maximum–The maximum amount
your policy will pay per year for dental care.
Co-payment– An amount that you the patient pays at the
time of service.
Covered
Services– A list of all the
treatments, services, and procedures the insurance policy will cover under your
contract arranged between the insurance company and your employer
Deductible– A dollar amount that you must pay out of
pocket each year before the insurance company will pay for any treatments or
procedures
Limitations/Exclusions– A list of all the procedures a dental
insurance policy does not cover
·
Coverage may limit the
timing or frequency of a specific treatment or procedure (only covering a
certain number within a calendar year), or may exclude some treatments
entirely. Knowing the limitations and exclusions of a policy is very important.
Member/Insured/Covered
Person/Beneficiary/Enrollee–
Someone who is eligible to receive benefits under a dental insurance plan
Provider– Any oral health specialist who provides
treatment
Waiting
Period– A specified amount
of time that the patient must be enrolled with an insurance plan before it will
pay for certain treatments.
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