{"id":783,"date":"2020-11-07T17:03:05","date_gmt":"2020-11-07T17:03:05","guid":{"rendered":"https:\/\/www.thedentalexpress.com\/downfalls-of-dental-insurance-use-it-or-lose-it-san-diego-dentist\/"},"modified":"2024-03-07T01:30:22","modified_gmt":"2024-03-07T01:30:22","slug":"downfalls-of-dental-insurance-use-it-or-lose-it-san-diego-dentist","status":"publish","type":"post","link":"https:\/\/www.thedentalexpress.com\/dental-blog\/downfalls-of-dental-insurance-use-it-or-lose-it\/","title":{"rendered":"Downfalls of Dental Insurance: Use it or Lose it – San Diego Dentist"},"content":{"rendered":"

A simple guide to understanding your dental insurance and getting the most out of your dental benefits.<\/h1>\n

Having dental insurance is like owning a Roomba.<\/p>\n

 <\/p>\n

You can bring your new Roomba home from the store and take it out of the box. You can take the plastic off and place it on the floor.<\/p>\n

 <\/p>\n

But if you don’t turn it on and set it up, it’s just going to sit there doing nothing.<\/p>\n

 <\/p>\n

Even if you bought the super-deluxe unlimited power model, if you don’t know how to make it work, then your floors won’t get any cleaner, and the money you spent will have gone to waste.<\/p>\n

 <\/p>\n

The same goes for your dental insurance coverage.<\/p>\n

 <\/p>\n

If you don’t take the time to learn what your benefits are and how your policy works<\/strong>, the only thing it will do is sit there collecting dust. Like a poor, useless Roomba.<\/p>\n

 <\/p>\n

The worst part about this situation is that you could be leaving a ton of savings<\/em> on the table.<\/p>\n

 <\/p>\n

Depending on what type of dental insurance coverage you have, you could be saving money on regular dental checkups, cleanings, and various treatment plans!<\/p>\n

 <\/p>\n

Our mission at Dental Express<\/strong><\/a> is to provide top-notch dental care while saving you as much money as possible. When it comes to your dental insurance coverage, transparency is our highest value.<\/p>\n

 <\/p>\n

To make sure you understand the full extent of your dental benefits, we’re going to cover the four downfalls of dental insurance and some useful tips you might not know on how to make your policy work for you.<\/p>\n

 <\/p>\n

The Four Downfalls of Dental Insurance<\/h1>\n

The two key takeaways from this article, if you learn nothing else today, should be to:<\/p>\n

    \n
  1. Know your benefits<\/strong>, and<\/li>\n
  2. Understand your policy<\/strong><\/li>\n<\/ol>\n

     <\/p>\n

    Understanding what your dental insurance coverage can do for you is the first step to reaping all of your dental benefits.<\/p>\n

     <\/p>\n

    What’s your yearly maximum? Do you know your deductible? Does your insurance cover the full cost of preventive care visits or only a portion?<\/p>\n

     <\/p>\n

    If you don’t know how to answer these questions, set aside some time to learn about your dental policy. Call your insurance provider to go over it with you if you need to.<\/p>\n

     <\/p>\n

    Your smile is worth it, and it could save you a lot of money.<\/strong><\/em><\/p>\n

     <\/p>\n

    To help with this process and put you on the fast-track to savings, we’re going to go over the four downfalls of dental insurance.<\/p>\n

     <\/p>\n

    These pitfalls are the main features to be aware of when understanding your dental insurance plan and how to take full advantage of it.<\/p>\n

     <\/p>\n

    Downfall #1: Waiting Periods<\/h1>\n

    Waiting periods are downfall number one because if you’re not careful, they can take you by surprise at the start of your dental coverage.<\/p>\n

     <\/p>\n

    A waiting period<\/strong> is set by your insurance provider and is the amount of time you have to wait before your dental insurance coverage takes effect.<\/p>\n

     <\/p>\n

    Waiting periods are put in place to keep you from scamming the system by signing up for coverage, getting a ton of dental work done, and then canceling your policy.<\/p>\n

     <\/p>\n

    But you would never do something like that…right?<\/p>\n

     <\/p>\n

    All jokes aside, not all dental policies have waiting periods, and not all waiting periods are the same<\/em>. Some waiting periods last longer than others, and some allow coverage for certain dental treatments while others don’t.<\/p>\n

     <\/p>\n

    Your plan might have you pay your premium for six months or even a year before your full coverage starts. Or, it might cover routine checkups but only provide partial or no coverage for major treatments.<\/p>\n

     <\/p>\n

    This variety in standards is why you need to read up on your dental insurance policy to see if it requires a waiting period, and if so, what the details are.<\/p>\n

     <\/p>\n

    People often get excited about starting or switching to a new policy during open enrollment, and without fully understanding their coverage, they head straight for the dentist.<\/p>\n

     <\/p>\n

    Little do they know, there’s a waiting period that keeps them from getting the affordable dental care they were looking for.<\/p>\n

     <\/p>\n

    Someone forgot to program their Roomba. Yikes.<\/p>\n

     <\/p>\n

    But don’t worry. At Dental Express<\/strong><\/a>, our treatment planners will go over your dental coverage with you before any procedures, so you know where you stand.<\/p>\n

     <\/p>\n

    Have complicated insurance questions? We’ve got simple answers<\/strong><\/em>.<\/p>\n

     <\/p>\n

    We’re always happy to clear up any confusion about your dental insurance coverage. Please don’t hesitate to give us a call or ask any questions you may have when you come into one of our offices in San Diego<\/strong><\/a> .<\/p>\n

     <\/p>\n

    In addition to waiting periods, pre-existing conditions can also heavily impact your dental coverage.<\/p>\n

     <\/p>\n

    Many plans will cover smaller pre-existing issues like cavities, but if you need more expensive care like partial dentures or a dental implant<\/strong><\/a>, your insurance may not help with the costs.<\/p>\n

     <\/p>\n

    These issues lead us to our second downfall: the missing tooth clause<\/em>.<\/p>\n

     <\/p>\n

    Downfall #2: Missing Tooth Clauses<\/b><\/h1>\n

    Many dental insurance plans have what’s called a “Missing Tooth Clause,” which is how insurances avoid paying for dental care that addresses pre-existing conditions.<\/span><\/p>\n

     <\/p>\n

    Say you get a tooth removed before signing up for a new dental insurance policy.\u00a0<\/span><\/p>\n

     <\/p>\n

    Because you got the procedure done before your coverage began, the missing tooth clause in your plan absolves your insurance of having to pay for the bridge or implant you want to replace your tooth with.<\/span><\/p>\n

     <\/p>\n

    Now, you’re stuck without an affordable solution to your issue. Either that or you’re stuck with the full cost of an expensive dental procedure you weren’t prepared for.<\/span><\/p>\n

     <\/p>\n

    Not exactly a fun situation to be in.<\/span><\/p>\n

     <\/p>\n

    Always make sure to look for a Missing Tooth Clause in your dental policy. <\/span>Read all the fine print.\u00a0<\/b><\/p>\n

     <\/p>\n

    And if you’re confused by the fancy language they use, <\/span>give us a call at Dental Express.<\/a><\/strong> We’re fluent in dental insurance.<\/span><\/p>\n

     <\/p>\n

    If you have a serious dental issue that needs attention and you’ve just signed up for a new dental insurance policy, discuss your options with your <\/span>San Diego dentist<\/a><\/strong> before moving forward with any procedures.\u00a0<\/span><\/p>\n

     <\/p>\n

    Depending on your issue, you may be able to get by with preventive care while you wait for your benefits to kick in, which will save you money in the long run.<\/span><\/p>\n

     <\/p>\n

    Downfall #3: Alternate Benefit Applies<\/b><\/h1>\n

    Alternate Benefit Applies is insurance lingo for, “We’re not going to pay for that because there’s a cheaper option. Sorry, not sorry.”<\/span><\/p>\n

     <\/p>\n

    If they respond with this line when you go in for treatment, your dental insurance plan is the type that covers only the minimal available treatment.\u00a0<\/span><\/p>\n

     <\/p>\n

    You might hear this when you go to get composite tooth colored fillings front teeth<\/a>, and they say they’re only willing to cover a metal amalgam. Or, you want to get a dental implant, but they’ll only agree to cover a partial denture.\u00a0<\/span><\/p>\n

     <\/p>\n

    “Alternate benefit applies.”<\/span><\/p>\n

     <\/p>\n

    When you’re shopping for affordable dental insurance plans, pay attention to how they cover these four types of care:<\/span><\/p>\n