Dental Insurance

What can you do with your dental insurance? If you have a dental insurance plan, then you may want to consider these 3 helpful tips.

 

  1. Are you on a Calendar Benefit or Rolling Year Coverage plan?

  • Many insurance plans allot your benefit coverage in a calendar year period. So, from January 1st to December 31st. Meaning, at the end of that benefit period, your coverage starts anew.  
  • Some insurance plans base your coverage on a rolling 12-consecutive-month period (not the same as a calendar year). So, it might be from July 1st to June 31st.  The rolling 12-month period starts with the date of the first covered cleaning in the series. For example, if you had your first covered cleaning on March 2, 2018 and a second covered cleaning on August 24, 2018, the TRDP will not pay for another cleaning until March 2, 2019—12 months from the first paid cleaning—or after.

 

  1. Do you have unused benefits?

  • Any unused dental benefits or discounts, whether connected to a basic or major plan, do not transfer to the following year.
  • If your treatment is diagnosed on a date within one year and then performed in another year (or coverage period, it could start over or change mid-year, see above) your discounts or coverage may be different than what you expected. Often times we encourage you to schedule your treatment as soon after diagnosis as possible for this reason!

 

  1. What is your reimbursement level?

  • Many insurance plans cover preventative things like a cleaning or even exam at 80-100%.
  • Most insurance plans have a tier of coverage depending on what category it falls within. E.g. Basic procedures, such as fillings and gum treatment, are usually reimbursed at a slightly lower percentage (for example, 70% to 80%).

Major procedures, such as crowns and root canals, are usually reimbursed at the lowest percentage (for example, 50%).

 

Bonus tip:

We are here to help. Regardless of your insurance plan type or even if you are self-pay, our office has a solution to get you in for the dental treatment you deserve. Please call us to get scheduled today.