Do you have dental insurance? If you have dental insurance, do you love it or hate it? Maybe you are frustrated or just flat out do not understand your plan!
Dental insurance is a blessing, but it can be a source of frustration for everyone. Services covers change; co-pays change. Today, insurance pays less than ever before but has more rules about what services are covered and denies many services.
Let’s start at the beginning. Dental insurance is a contract with your employer or you and the insurance company. Either your employer (or you) decides on a plan. It is based on cost per month, also called a premium. And the premium cost is based on the number of services covered by the plan. The more coverage, the higher the monthly premium. Of course, there are limits.
• There may be a yearly maximum dollar amount per person. Once you reach the maximum dollars your insurance will pay in one year, no more dental care is paid for by the insurance company until the renewal year.
• There IS a maximum dollar amount per procedure. All insurance companies have this. For example, an insurance company may pay 100% of the cost of dental x-rays up to a certain amount. They may limit the amount they will pay to $45. If your dentist charges $50, the insurance company will still pay only $45. You are responsible for the difference between insurance coverage and the actual cost.
• There may be a yearly dollar maximum per family. All family members services are paid from the “pot” of the total yearly maximum allowed for your family. So, the more family members you have, the less money each individual family member gets for their dental care because the money gets split up.
Every insurance company has multiple plans. These plans have different yearly maximums and different total maximum amounts they pay per dental procedure. It can be overwhelming and confusing, can’t it?
Your employer may switch insurance companies, or your employer may change plans within the same insurance company, or you may get a different plan if you change employers. Then, you’re back to square one and need to determine the types of maximums you have (see LIMITS ONE, TWO AND THREE) and the amounts of co-pay you are responsible for. Whew!
Life-Centered Dentistry to the rescue! Gone are the days of dental insurance covering all your dental health needs. The insurance experts at Life-Centered Dentistry will educate you about your particular plan and maximize your dental insurance benefits. We empower you to make the best decision for dental health by combining the maximum your insurance company allows each year with your finances.
Dental insurance companies do NOT determine the dental care that’s best for you. That’s Dr. Ludwig’s job. He sees you and your dental health needs and recommends the best care for you. With your input, Dr Ludwig and the team take you along a treatment path that helps you achieve your goals for your dental health and your best smile ever!