5 Hidden Truths About Dental Insurance

5 FACTS ABOUT DENTAL INSURANCE

(Hidden Truths)

FACT 1: No insurance plan is pay-all. It is only designed to aid in payment. Most have yearly maximums or deductibles and pay only a portion of many procedures.

FACT 2: The less paid for the coverage, the less the patient receives in benefits. The amount the plan pays is determined by the coverage purchased by the employer. Many insurance companies state they pay 80% to 100%. In spite of what is stated, most plans cover less than the average fee. This can be very confusing for patients.

FACT 3: Remember, patient gets back in benefits what his or her employer paid toward the plan less the insurance company’s profits and administrative costs. This is a basic business principal. Some insurance companies inform their subscribers that the doctor’s “fees are above usual and customary fees,” rather than saying “your benefits are low.”

FACT 4: Unfortunately, some routine dental services are not covered by insurance plans. Most insurance companies provide a list of benefits either on a website or in a booklet provided by the employer. If you are uncertain, it is best to ask the dental office for a pre treatment estimate to avoid unexpected expenses.

FACT 5: Generally, the PPOs and HMOs offer lists of participating doctors. This does not always mean that it is a requirement for the patients to choose a doctor from that list. Patients may still have the freedom of choice.

Insurance plans are a wonderful supplement for patients, but patients must be made aware of the hidden truths about their coverage.  It is wise to be an informed consumer in this age of high medical costs.