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Determining which dental insurance plan is the best option for your family during open enrollment can be a challenge. There is no one-size-fits-all answer when it comes to employees and their family’s specific needs for insurance. Feel confident in finding the best dental plan for you and your loved ones by following these tips during the open enrollment season.
Dental Insurance Basics
When it comes to understanding the dental insurance benefits your company is offering, the first step is to determine what is considered in-network versus out-of-network.
In-Network
To be an in-network dental office, the practice has to agree to use specific treatments, materials, and to charge what the insurance plan deems as a fair and average price. An in-network dental office works with the insurance provider who chooses what treatments will be covered under the specific insurance policy.
Out-of-Network
An out of network dental office can recommend and provide any dental treatments to patients and are also responsible for charging prices as they seem fair. An out-of-network dental office allows patients to have the flexibility to choose treatments that look and feel more natural as opposed to only being offered limited materials and treatments that will be covered. These attractive options and upgrades often end up costing the patient more out-of-pocket costs.
Know the Details of Your Plan
Taking the time to review the details of dental policy options with a trusted dental office can be the difference between unexpected out-of-pocket costs after a treatment verse having treatments covered. Most dental insurance plans include regular preventative care at 100% coverage. The best way to ensure you are using the coverage you are paying for each month is to use your allotted annual cleanings and exams.
Check The Annual Dental Insurance Maximums
Your dental plan maximum is the most money your insurance plan will pay towards your dental care each calendar year. Your dental insurance plan gives you a maximum for what can be spent on your annual dental care. This amount varies between insurance companies, and averages around $1,000 per person, per year. These maximums are typically reset at the end of the year. Any unused benefits will be forfeited and will not roll over to the next year.
Determine Out-of-Pocket Costs
In addition to the monthly premium amount you will be required to pay for a dental insurance plan, you will also be responsible for any out-of-pocket costs that are not covered under insurance. The amount of money that you are required to pay out-of-pocket before your benefits begin to take effect is commonly referred to as a deductible. Varying between insurance companies, your deductible is outlined in the details of your plan. Deductibles can be higher if your preferred dentist is outside of your network.
Pro Tip: When your dental insurance renews every January, you will be required to pay your deductible again before you can begin taking advantage of your benefits. Additionally, any unused benefits will be forfeited and will not roll over to the next year, so take advantage of these opportunities to save money before your benefits expire on December 31st!
Research Which Treatments Are Covered
Dental insurance plans will commonly cover what is considered preventative care. This coverage often includes two professional cleanings and exams per calendar year. Professional teeth cleanings performed by a trained dental hygienist every six months are considered routine care, in addition to exams performed by a dentist. Most standard dental insurance policies will also cover a certain percentage of a restoration treatment based on the predetermined maximum of your specific plan, including:
- Preventative care, such as bi-annual cleanings, exams, and x-rays
- Basic procedures, including fillings, root canals, and extractions
- Fluoride treatments for children
- Some major procedures, such as dentures, crowns, bridges, and implants
Consider a Flexible Spending Account
Funds from a Flexible Spending Account (FSA) or Health Savings Account (HSA) can be used towards any out-of-pocket costs associated with dental treatments and services. As long as the procedure is deemed medically necessary, utilizing spending accounts to help cover treatment costs comes with tax benefits related to your account.
Hoffman Dental Care is more than happy to review dental insurance plan options with our patients to ensure you are selecting the best insurance plan for your family. Call us today if you need help with choosing a plan that’s right for you.
