Dental Insurance Basics – Understanding How Dental Insurance Works
The simple answer to the question posed in the title is: How does dental insurance work? Simply put, dental insurance is a contract involving you and your dental health benefits provider, Delta Dental of Washington, if you select their Dental Insurance plan. When you sign up for an individual dental plan, you’ve entered into a legally binding contract.
This contract will outline what you pay for, how you’ll get your services paid for, what’s covered under the plan, when you must pay and any restrictions or caps that may apply. One of the most important things you must understand and appreciate about how dental insurance works is that it’s a service for which you must pay. Unlike many other types of insurances, such as life, automobile or other, dental services are not available for a variety of reasons, some of which are fairly expensive. To put it simply, there are situations where getting your teeth fixed costs more than simply whitening them. For this reason, you must pay a fee upfront to start the plan, even if you later decide to cancel it.
How does dental insurance work? To start to answer that question, first let’s take a brief look at how dental insurance works under the terms of Delta Dental’s Individual Dental Plan. Under this plan, an insured individual pays a pre-determined premium monthly. Once a month, the insured individual must pay his or her specified deductible, which is the amount the insured pays for professional dental procedures performed during that month. If the insured doesn’t pay this deductible in full, the insurer must reimburse the individual by paying a percentage of the total cost of the procedure plus the applicable service charge.
Most people are familiar with the term HMO or PPO. Those two terms are often used interchangeably, but they actually mean two different things. An HMO is usually a limited service provider. Some HMOs restrict the number of visits covered and/or the type of services covered. An HMO plan may limit the number of treatment days you can receive and the number of procedures you can have done in a year.
Another way how dental insurance plans work is through the POS or Point of Service plan. This type of plan requires you to pay your first visit or the maximum number of treatments within a specific period of time. Usually, you must pay your initial visit up front and then select treatments within a range of fees that you agreed to. These types of plans usually include emergency and major dental procedures. You cannot choose which services are covered by this plan.
A flat fee dental plan is another type of plan that you may hear about. In this case, the insured pays a flat fee for all dental services. This type of plan typically covers major and emergency dental services as well as some elective services. The cost of the flat fee varies from plan to plan. There are even some dental plans that cover the entire cost of all dental services at a discount.
If you don’t already have a dental insurance plan, or you currently do not have one, you need to learn how dental discount plans work. A discount plan allows you to save money on dental services. When you get a flat fee dental plan from your dentist, the insurance company pays the actual cost of your dental care. This eliminates the cost of “surprises” when you visit the dentist. Your insurance company will also provide preventive care at a reasonable price, which is great for those who do not have dental coverage.
How does dental insurance work? It really depends on what type of plan you get from your dentist. If you choose the right plan, your dentist may automatically cover all of your visits and preventative services. You may be able to save money if you choose a plan that offers discounts for certain services, such as regular cleanings and fluoride treatments. If you do your homework, however, you can find a plan that offers everything your dentist offers in one location, eliminating any guesswork on how the process works.