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How Do Dental Insurance Plans Work?


Posted on: Tuesday, May 8th, 2018

How do dental insurance plans really work? Figuring out Isn’t too hard!

The time has come: You must  choose a dental plan. It could be for a variety of reasons  – you’re starting your own business, you’re starting a new job and need to have something to cover you and your family.  It may seem daunting at first due to the sheer number of choices out there. Don’t panic. All you have to do is some research and then understanding the inner workings of dental plans will seem easier. Let’s dive in, shall we?

Types

It’s not going to be as simple as having only one choice. There are three different types of dental health insurance to pick from: HMO, PPO, or indemnity plan. They may sound like cable channel abbreviations, but these are actually simpler! HMO stands for Health Maintenance Organization and it means that the dentist that you decide on has to be within the network or you will have to certain out-of-pocket fees for seeing a different one. You’ll like this one if you live nearby but you’ll be grinding your teeth if you have to travel great distances to see your dentist – and they’ll have to treat you for that. The second type is PPO (Preferred Provider Organization), which means you can see dentists outside the network. A lot of people like this option, since that means they can pick a local dentist and not worry about costs.  An indemnity plan means that you can pick the dentist and the plan will pick up a certain percentage of the costs.

Here’s something to consider vis a vis the PPO versus the indemnity plan, here’s something to consider: If you’re using a dentist in the PPO network, they tend to charge less for procedures – so you would most likely pay less than what you’d pay for the same procedure in an indemnity plan. That means you will probably get money back in your pocket and that’s great… especially around the holiday times.

Coverage

Now here comes the more in-depth things about dental health insurance. Normally, when people get dental insurance, they are covered at 100% of routine dental visits, such as cleanings and checkups. Then they get 80% coverage for things like basic procedures like fillings and root canals.  When it comes to advanced procedures like bridges and crowns, they are covered for 50%.

Don’t assume that every plan is like that though –  read them thoroughly, otherwise you might be shocked when you get your dental bill and see what you owe for your visit(s). It seem boring and tedious, but spending a few minutes looking over the fine print of your plan can be well worth your while. It’s not like just clicking on “OK” when installing a new program. Should you have any questions, just contact the insurance company – they will be glad to answer your questions.  That way, when you finally sit down in the chair and have the dentist/specialist go to work on your mouth, you won’t have any worries.

Waiting Time

Oh yes, there’s a bit more. You can choose between a group or an individual plan. The group plan means less waiting time. If you’re deciding to go with an individual plan, you’re going to need to look closely at your calendar due to the likelihood of your having a much shorter window of time for procedures. That means you need to be on top of things if you’re planning on going on vacation and want work done beforehand. This is where reading the fine print comes in VERY handy

Other Things To Consider

Dental insurance plans are usually very different from health insurance plans in that you won’t be denied if you have a pre-existing condition. Again,research that beforehand.  Cosmetic dental work will likely result in your having to pay for it out of pocket, since insurers don’t consider that necessary, and they would probably only change their minds should there be very extenuating circumstances.

Don’t be intimidated by all this. The people at Ivory Dental in Jacksonville will be glad to work with you through your insurance situation. Just take a deep breath and give them a call at (904) 998-1555 and the friendly staff there will be delighted to discuss the entire matter.

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The patient and any other person responsible for payment have the right to refuse to pay, cancel a payment, or to be reimbursed for any other service, examination, or treatment which is performed as a result of and within 72 hours of responding to the advertisement for the free, discounted fee service, examination or treatment. Fees quoted are minimum fees only.

License # DN16915. Dental Codes for patient specials: D0150, D0210, D1110.

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