Submitted by: Sean Goudelock
Anyone who wants to purchase a dental insurance plan should know some of the basics like the 3 C s of dental insurance namely coverage, cost and claims. Whether you are looking for an individual or group plan, you would surely need to deal with them.
Coverage
The first thing you need to look for in any dental insurance plan is its coverage. Three questions that should be answered are as follows:
1. What major dental care is covered?
2. What preventive and diagnostic dental services will the plan cover?
3. What emergency and corrective dental services will be covered?
Most plans will cover about 50% of a major dental care s total cost or even less. Most of them even have a limit or maximum number of procedures or amount that you can spend for major dental care services. It is important that you know the restrictions of your plan when it comes to major dental services like oral surgery, restoration, implants, and orthodontics (i.e. braces and retainers).
Preventive and diagnostic dental services like initial and recall examinations as well as teeth cleaning are also important. They can help you avoid major dental services and corrective dental treatments. Most dental insurance plans would give you the basic preventive and diagnostic dental care without copayments. Keep in mind that some companies specify a limit on how often or how many times you can get preventive and diagnostic dental services. Check them when insurers give you dental insurance quotes because you will need to pay for other services once the annual limit is reached.
Most dental insurance plans will also cover for some corrective treatments like tooth removal, scaling, root planning, repair of dentures and bridges, and tooth nerve removal.
Cost
Most individuals would surely want to get an affordable or at least a competitively priced dental insurance plan. The best way to find them is to request for dental insurance quotes for plans with the same coverage from various companies and compare them.
You should also do a pre-treatment estimate especially if you are in need of dental treatments and you want to lessen the out-of-pocket cost. Ask your dentist about the treatments and their costs that you will need before asking for dental insurance quotes from companies. The pre-estimates typically help patients determine that treatments that they need to know if they will exceed the annual limits.
Another way to reduce the cost of your dental insurance premium and deductibles is to take care of your teeth and gums very well. You will need less professional dental care services this way.
Claims
Filing claims can be done by the patient or by the dentist. It actually depends on the plan. Most PPO or DHMO will have the dentist responsible for filing claim. However, you should ask for the procedures and how easy (or difficult) it is to file a claim to a certain insurer. Past clients might be able to give you some details.
Normally, you will need to complete a claim form and attach a copy of statement of treatment to be issued by the dentist. You will then need to send or submit it to the insurance company. It is not necessary but it may help if you will keep a copy of the form and statement of treatment.
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