{"id":3607,"date":"2021-06-21T16:03:59","date_gmt":"2021-06-21T16:03:59","guid":{"rendered":"https:\/\/www.thedentalexpress.com\/?p=3607"},"modified":"2024-03-07T01:23:13","modified_gmt":"2024-03-07T01:23:13","slug":"the-patients-guide-to-understanding-dental-benefits","status":"publish","type":"post","link":"https:\/\/www.thedentalexpress.com\/dental-blog\/the-patients-guide-to-understanding-dental-benefits\/","title":{"rendered":"The Patient\u2019s Guide to Understanding Dental Benefits"},"content":{"rendered":"
The Patient\u2019s Guide to Understanding Dental Benefits<\/p>\n
Getting to know your insurance plan can be a lot like reading a menu that\u2019s in a different language\u2026<\/span><\/p>\n <\/p>\n But understanding the dental benefits that come with that plan is the best way to make the most out of your coverage.<\/span><\/p>\n <\/p>\n Aside from becoming familiar with your deductible, co-payments, and annual maximum, there are several benefits to look out for that can help you get your dental care needs taken care of at a reasonable price.<\/span><\/p>\n <\/p>\n Whatever your dental insurance status may be right now, this guide can help you:<\/span><\/p>\n <\/p>\n <\/p>\n To start, let\u2019s cover the basics\u2026<\/span><\/p>\n <\/p>\n These items are the building blocks that make up your <\/span>insurance plan.<\/b><\/a><\/p>\n <\/p>\n It\u2019s crucial to make sure the foundation of your policy is rock solid so you can save as much money as possible whenever you visit your San Diego dentist.<\/span><\/p>\n <\/p>\n To paint a picture of what an ideal dental insurance plan might look like, we\u2019ll be doing a brief overview of these three essential elements.<\/span><\/p>\n <\/p>\n Your deductible is the amount you have to pay before your coverage takes effect.<\/span><\/p>\n <\/p>\n For the sake of simplicity, let\u2019s say your dental insurance deductible is $100, and you need a treatment that costs $200.<\/span><\/p>\n <\/p>\n That means you\u2019ll pay the first $100, and your insurance will take care of a percentage of the rest.<\/span><\/p>\n <\/p>\n Usually, your plan will assign you an annual deductible, and you\u2019ll work towards reaching it as you get dental treatments throughout the year.<\/span><\/p>\n <\/p>\n Ideally, the lower the deductible, the better\u2026<\/span><\/p>\n <\/p>\n But most dental plan deductibles are already fairly low \u2013\u2013\u00a0usually anywhere from $25-$100. The part that can get pricey is the portion you have to pay after you\u2019ve met your deductible and your insurance has covered their percentage of the remaining cost.<\/span><\/p>\n <\/p>\n This is called the \u201cpatient share\u201d or \u201cpatient portion.\u201d<\/span><\/p>\n <\/p>\n Of course, you still want a low deductible, but a lower patient portion is arguably just as valuable.\u00a0<\/span><\/p>\n <\/p>\n However, plans with lower patient portions typically have higher premiums and vice versa.<\/span><\/p>\n <\/p>\n If you can spare the cash and you know your smile needs extra attention, the lower patient share might be worth the higher premiums.<\/span><\/p>\n <\/p>\n It all comes down to your budget and dental care needs.\u00a0<\/span><\/p>\n <\/p>\n You know your smile better than anyone, so take all this into consideration when choosing a dental insurance plan that\u2019s right for you.<\/span><\/p>\n <\/p>\n If you can, find a policy that doesn\u2019t require a deductible for routine cleanings, <\/span>exams<\/b><\/a>, and other preventive services.\u00a0<\/span><\/p>\n <\/p>\n Most don\u2019t, but it never hurts to check!<\/span><\/p>\n <\/p>\n Co-payments or co-pays are kind of like ride-sharing with your insurance provider.<\/span><\/p>\n <\/p>\n Depending on what plan you have, whenever you go to the dentist, they\u2019ll take care of a percentage of the appointment fees once you\u2019ve met your deductible, and you\u2019ll be responsible for the rest.<\/span><\/p>\n <\/p>\n For example, if each dentist visit costs $100, your insurance may cover $80 of it, leaving you with a $20 co-pay.<\/span><\/p>\n <\/p>\n But this patient’s share is rarely fixed. It all depends on the dental care you\u2019re receiving, so your cost will vary from visit to visit.\u00a0<\/span><\/p>\n <\/p>\n The lower the patient portion, the lower your co-pays will be. But again, the high-premium trade-off still applies here.<\/span><\/p>\n <\/p>\n Our last foundational item is the annual maximum, which is fairly self-explanatory.<\/span><\/p>\n <\/p>\n Your annual maximum is the most your dental insurance policy will pay in a year.<\/span><\/p>\n <\/p>\n So, if your annual maximum is $1,500, your dental insurance will pay a percentage of your care (after you\u2019ve met your deductible) up to $1,500 a year.\u00a0<\/span><\/p>\n <\/p>\n After that, any extra expenses have to come out of your pocket.<\/span><\/p>\n <\/p>\n This is another situation where you have to consider your dental care needs.\u00a0<\/span><\/p>\n <\/p>\n If you anticipate making frequent trips to your San Diego dentist for the foreseeable future, you may want to look for a high annual maximum.\u00a0<\/span><\/p>\n <\/p>\n And if you\u2019re already locked into your current plan and need some more wiggle room, feel free to ask your employer about how to raise your maximum.<\/span><\/p>\n <\/p>\n Combining these three crucial components in a way that works best for your smile and budget is the key to maintaining a healthy and happy mouth.<\/span><\/p>\n <\/p>\n Now, for the moment we\u2019ve all been waiting for…<\/span><\/p>\n <\/p>\n If you\u2019re unsure of your benefits or need guidance on what to look for when shopping for a plan, going it alone can be intimidating.<\/span><\/p>\n <\/p>\n But don\u2019t worry.\u00a0<\/span><\/p>\n <\/p>\n In this section, we\u2019ll be going over some recommendations from the <\/span>American Dental Association (ADA)<\/b><\/a> as well as our very own team of treatment planners.<\/span><\/p>\n <\/p>\n By the end, you\u2019ll have a strong grasp of what benefits work for you as a patient and how well your current plan addresses your dental care needs.<\/span><\/p>\n <\/p>\n Here\u2019s a list of questions to ask yourself when looking over (or looking for) your dental insurance plan:<\/span><\/p>\n <\/p>\n Finding a <\/span>good dentist<\/b><\/a> is hard enough.\u00a0<\/span><\/p>\n <\/p>\n If you\u2019re happy with your current dental provider and your insurance plan requires you to find a new one, it may be time to look for other options.<\/span><\/p>\n <\/p>\n The <\/span>ADA<\/b><\/a> backs up this statement, recommending that patients go with a plan that allows them to choose their ideal dentist.<\/span><\/p>\n <\/p>\n With a family dentist like Dental Express, specialist referrals are few and far between.<\/span><\/p>\n <\/p>\n But depending on your dental health, they can be necessary from time to time.\u00a0<\/span><\/p>\n <\/p>\n If your insurance plan doesn\u2019t allow for specialist referrals, then you may have to explore other payment methods like <\/span>Medi-Cal Dental<\/b><\/a> (if you\u2019re a California resident), low-interest medical financing, or simply paying out of pocket.<\/span><\/p>\n <\/p>\n In your quest to find the ideal dental policy, make a point to look for one that offers coverage for specialist care.<\/span><\/p>\n <\/p>\n Some dental insurance plans have waiting periods, requiring you to wait a certain amount of time before your benefits kick in.<\/span><\/p>\n <\/p>\n As crazy as it sounds, depending on what plan you end up with, you could be waiting anywhere from a few months to a full year!<\/span><\/p>\n <\/p>\n This can be a huge problem if you have urgent health needs or a pre-existing condition.\u00a0<\/span><\/p>\n <\/p>\n If you know you\u2019ll be seeing the dentist often, look for plans that don\u2019t include waiting periods.\u00a0<\/span><\/p>\n <\/p>\n According to the <\/span>ADA<\/b><\/a>:<\/span><\/p>\n <\/p>\n \u201cEven though your plan may have a waiting period, you may still need immediate treatment to keep your mouth healthy.\u201d<\/span><\/i><\/p><\/blockquote>\n <\/p>\n If you\u2019re in the middle of a waiting period and need care, contact your insurance provider to see if there\u2019s a way to shorten it, or get in touch with your local <\/span>San Diego dentist<\/b><\/a> for affordable financing or other options.<\/span><\/p>\n <\/p>\n Dentistry is a team effort between you and your provider that requires trust and integrity\u2026<\/span><\/p>\n <\/p>\n And unfortunately, finding a provider that has your best interests at heart isn\u2019t easy.<\/span><\/p>\n <\/p>\n That\u2019s why at Dental Express, every decision we make starts with YOU.<\/span><\/p>\n <\/p>\n We\u2019ve made it our mission to remove as much financial stress from dentistry as possible.\u00a0<\/span><\/p>\n <\/p>\n If you need a series of treatments, but your budget can only accommodate so many a year, then we\u2019ll space them out to fit comfortably into your lifestyle.<\/span><\/p>\n <\/p>\n We pride ourselves on putting patients first, and it\u2019s our promise to you and the people of San Diego to continue doing so.<\/span><\/p>\n <\/p>\n Whatever your dental coverage looks like, we\u2019ll work with you to maximize your benefits, savings, and dental health.<\/span><\/p>\n <\/p>\n If you have any questions about your insurance or you\u2019d like to get started, you can schedule an appointment online or give us a call at <\/span>any of our locations.<\/b><\/a>\u00a0<\/span><\/p>\n <\/p>\n We\u2019d love to help you apply your benefits at Dental Express!<\/span><\/p>\n <\/p>\n Did Your Employer Change Insurance Plans? Here\u2019s What to Do<\/b><\/a><\/p>\n 5 Ways to Secure Dental Coverage if You\u2019re Unemployed<\/b><\/a><\/p>\n Downfalls of Dental Insurance: Use it or Lose it<\/b><\/a><\/p>\n\n
Deductibles, Co-pays, and Annual Maximums<\/span><\/h2>\n
Deductibles<\/span><\/h2>\n
Co-Payments<\/span><\/h2>\n
Annual Maximums<\/span><\/h2>\n
The Patient\u2019s Guide to Understanding Dental Benefits 101: Everything You Need to Know<\/span><\/h2>\n
Can I Pick My Dentist?<\/span><\/h2>\n
Can I See a Specialist?<\/h2>\n
Does My Plan Have a Waiting Period?<\/span><\/h2>\n
Maximize Your Benefits (and Savings) at Dental Express<\/span><\/h2>\n
Keep Reading<\/span><\/h3>\n