You pay your premiums every month, and your vaguely know that dental insurance is important. But do you understand how it works? If all of the technical-sounding words your insurance company uses are confusing to you, you’re not alone. Many Americans don’t completely understand their benefits and end up overpaying for their treatments as a result. Read on as your dentist in Chesterfield gives four tips to help you maximize dental insurance benefits.
Always Ask for a Pre-Determination of Benefits
Before going through with a treatment more extensive than a regular checkup and cleaning, ask your Aetna dentist in Chesterfield to send your insurance company a pre-determination of your benefits. They’ll process the estimate and then deliver a statement showing exactly what your insurance policy would cover for that particular treatment. That way, there will be no surprises when it’s time to pay for your procedure.
Remember That “Out-of-Network” Doesn’t Necessarily Mean Zero Coverage
If a dentist is “in-network” for you, that means they have partnered with your insurance company to offer discounts on treatment. For the most cost-effective dental care, it’s highly recommended that you see an in-network dentist. However, just because you’re out-of-network doesn’t automatically mean you won’t receive any coverage. It simply means that the percentage of your treatment covered by your insurance may be reduced.
Know Your Deductible and Annual Maximum
Two important dental insurance terms to know are:
- Deductible: The amount you must pay out of pocket before your insurance begins covering your care.
- Annual maximum: The highest amount your insurance company will put toward your dental care in a given period, usually a calendar year.
Once you’ve met your deductible, your insurance will pay for a portion of your treatments for the rest of the year until you reach your annual maximum.
Attend Two Checkups and Cleanings a Year
Every dental insurance plan is different, but you can expect your coverage levels to look something like this:
- 100% of preventive and diagnostic care, such as checkups and cleanings.
- 70-80% of basic restorative treatments like fillings and gum disease therapy.
- 50-70% of major procedures, including crowns, bridges, and dentures.
Routine checkups and cleanings are the best way to avoid needing major, pricier procedures down the road. Not only can the hygienist remove harmful plaque, but your Delta Dental dentist in Chesterfield can spot potential issues before they become more complicated and expensive to treat. Skipping these appointments could cost you more in the long run, so don’t forget to schedule two of them a year!
Keep in mind that every dental insurance policy varies, so you’ll need to examine your specific plan to find out what it covers. If you need assistance, your dentist and their team would be more than happy to help. Just give them a call!
About the Author
Dr. Jeff Yenzer is a Guardian dentist in Chesterfield, MO who graduated with honors from the University of Missouri in Kansas City’s dental school in 2002. His practice is in-network with several dental insurance plans, including Sun Life, Aetna, Delta Dental, Guardian, and Cigna. To learn how much money you can save by scheduling a checkup with Dr. Yenzer before the year ends, contact him on his website.