When Dental Insurance May Not Be Enough

The Care Credit Safety Net

It always pays to be budget-conscious, especially in these uncertain economic times that we live in. No matter what our income or career situation may be, a well-thought out budget enables us to make do with what we have at the moment. After all, we are responsible for ourselves. A little economic forethought can go a long way to providing greater financial security. Look at it this way, almost every successful person on earth, at one time or another, developed a game-plan that helped them to achieve their dreams. In many ways, a budget is your game plan for paying important bills, providing contingencies for unforeseen circumstances and building a solid foundation for a bright future. An important part of your game plan should be to make sure that you, as an individual or as the head of your household, have some kind of medical and dental Insurance. You simply cannot afford not to be covered. All it takes is for one major emergency to occur, such as an accident that requires dental surgery and implants, and financial catastrophe awaits.

Why would you put yourself in such an untenable position, financially, if you could avoid it? Future articles will look at different definitions and types of dental Insurance that your employer may offer or that can be purchased on your own. But for now, let us look at the basics.

What services and treatments do dental plans cover?

There is no one answer to this question. Different insurers and types of plans offer a wealth of coverage. You may have to shop around in order to find the “plan” that is right for you. Deductibles and co-pays will also figure into making your choice of provider. This is where your budget will certainly come in. Your household budget will dictate which type of plan you can afford, particularly if you are purchasing coverage on your own. For insurance provider purposes, dental care is grouped into three areas of coverage or categories, preventative, basic and major.

Preventive care includes, at least one dental examination or check-up visit per year. Some plans will cover two visits per year. The idea is for you to be in a financial position where the insurance will enable you to obtain quality preventive care. If your dentist sees signs of cavities and/or gum disease early on, this helps your long term oral health and keeps costs down for the insurance provider. Quite possibly, you will not need more expensive treatment options or dental surgeries, down the road. Preventive care is cost effective and everybody wins. Usually, coverage will include the exam itself, a series of x-rays as well as a cleaning and polishing.

Basic procedures are defined as the treatments or procedures that address routine dental issues or problems. This would include having a cavity filled, a tooth extracted, a root canal, as well as treatment that may be required for Gingivitis or Periodontal disease.

Major procedures often require the highest co-pay. Mostly, these procedures are time consuming and also involve expensive dental appliances and lab work to be done. Dentures, restorations such as crowns, inlays, partial bridges and implants fit into this category.

If you or your child need or want to get braces, then this is more of a grey area as far as insurance coverage goes. Some policies cover Orthodontics, while others do no or you have to have a special addendum or rider put into the paperwork for the plan that you have selected.

Even if you have what is considered to be “excellent dental coverage”, you may still be liable for moderate to considerable out of pocket costs and expenses. Many employer driven plans are designed to only pay for a portion of your dental related treatments and procedures. An “insider” term that is used in the industry is “usual, customary and reasonable” or UCR. This refers to the reimbursement levels that the insurer will pay for different types of treatment that you receive. There could be a big gap between what the dental plan administrator determines is a customary or reasonable fee for the oral surgery that your dentist just performed and what the dentist actually charges you. Then you will have to make pay out of pocket.

Managed care dental plans are famous for restricting the type and frequency of care and treatment, as well as controlling the level of reimbursement for dental services rendered. If you have a managed care plan, you have to be vigilant when it comes to watching that those out of pocket expenses do not break your budget. Your insurer will not keep an eye on things, that is for sure. It is your responsibility!

What is a care credit and why is it smart to get it?

Care Credit is not dental Insurance. Let us get that aspect of things right out of the way, so there are no misconceptions. Care Credit is a healthcare credit card, that can be used to supplement your existing dental coverage and pay for those annoying out of pocket costs that we just talked about. Care Credit picks up where most insurance plans leave off. There is no reason why you cannot use it to pay off co-pays and deductibles.  If you do not have insurance, then you can also use Care Credit to pay for many dental treatments and procedures. Using this very special type of credit card can actually help you manage your family’s dental and other health care-related expenses.

On a practical level, Care Credit presents another option for paying your dentist, so that you do not have to get cash at the bank or put the payment on your other cards like Visa, American Express or MasterCard. You may be using one of these cards for day to day expenses or perhaps you do not want to add the cost of that root canal to the card. Care credit gives you different financing options that you probably cannot get at your dentist’s office. They offer short term financing options from 6 to 24 months with no interest charged if certain conditions are met. Long-term financing is also available as are fixed monthly payments. Keep in mind that, as with all types of credit cards, you will receive a designated line of credit, after the approval process is finished. Your card does not have an expiration date. You can use it as long as your account is in good standing.

Unlike some dental plans, Care Credit is all encompassing. Their dental financing options include preventive dentistry financing, which are check-ups every six months, Periodontics, fluoride treatment, sealants, ceramic fillings, Periodontal disease prevention, scaling, cleanings and even mouth guards.

Cosmetic dentistry procedures are usually not covered under typical dental plans, or as we previously mentioned, the co-pay is sky-high. That is not a problem if you carry the Care credit card. Restorative and cosmetic dentistry financing and procedures include, Lumineers, veneers, dentures, tooth repair, braces and retainers, bite plates, root canals and dental implants. Remember that Care Credit is not meant to be a substitute for or replace dental insurance. But it is a handy option to have available. As with any credit card, you have to budget yourself and keep track of your expenditures. You never want to take on more expenses than you can afford.

Dental.net does not endorse or have any affiliation with Care Credit.  Whether you are deciding on a dental treatment and procedure, insurance coverage or a dental credit card, you have to factor in what works for you and your particular financial and medical needs. The power to decide is yours and yours alone. And, as  always, that is what dental.net is all about, which is empowering you with the information you need to do your own follow-up research, ask questions of your dentist, hygienist and insurance provider and see what is best for you.