What Does Dental Insurance Normally Cover?
Most of us are aware of what we get with insurance cover before we enter the contract stage, and that is because we either ask questions before deciding, or we read the handouts in detail. One of the most frequently asked questions is: “what does the policy cover”? But the answer is not that simple as each provider supplies slightly different types of coverage. That is why you need to focus on precisely what you are buying before you sign. Check the exclusions and exceptions carefully. It is far better to know what you are entitled to before expensive dental surgery, than to be in for a major shock when submitting an insurance claim that may be repudiated.
What to Expect:
Dental insurance offers different co-payment levels for different levels of care. This might result in some procedures being fully covered while others will require you to pay an agreed portion of the total cost. Typically, the following may apply:
• Diagnostic and preventative care. This will usually fully cover these dental procedures or only require a small co-payment from you. These include check ups, x-rays, routine cleaning, fluoride application and certain other preventative measures used in avoiding tooth and gum disease. However, what actually gets covered by a plan like this will vary between providers so it is important to determine your entitlement.
• Basic procedures. Expect to make a small co-pay contribution for routine procedures such as cavity filling, tooth removal and repairs to teeth that are cracked or chipped. Sometimes providers will even include root canal surgery in this category.
• Major dental care. Discuss with your dentist what to expect in terms of upcoming major dental care, and clearly understand what your provider will and will not cover. Furthermore, you may also be subjected to a waiting period before cover kicks in. Dentures for example, may have a waiting time of up to six months after a Dental Plan has been agreed. Generally, braces, surgery, implants and dentures may follow the same pattern.
There is absolutely no doubt that dental insurance offers a great value and peace of mind. When buying one, keep in mind that certain elective or cosmetic procedures may not be covered by your provider. The range of options available can be overwhelming – make quite sure that the cover that you are arranging is the best fit possible for your specific situation.