5 Things You Should Know About Dental Insurance

As West Hartford dentist, Dr. Elzbieta W. Basil, DMD has written about extensively, receiving proper dental care is important, not just for your teeth and gums; it is essential to a healthy body.

Dentists, like Dr. Basil, with offices in West Hartford Center and Downtown New Britain, Connecticut, understand that dental care costs money. Even routine, preventive care can have an impact on a family budget — not to mention treatment for disease or injury. As with other healthcare costs, people often turn to dental insurance to help soften this financial impact.

But is dental insurance right for you and your family?  Here are 5 things you should know if you have insurance or are thinking of getting it. 

Dental insurance operates differently than other types of insurance.

We often understand “insurance” as protection against unforeseen expenses. Dental insurance, though, works more like a “discount coupon” to offset dental care costs. It's important, therefore, that you know what your plan pays for (routine care and treatment, orthodontics, cosmetic enhancement, etc.), at what percentage (50%, 80%) of the usual and customary fee. Find out what the plan refers to as the “usual fee” as that can be much less than 2017 costs and any annual deductible, the amount you pay before the policy pays. Also, there is always a cap as to the maximum benefit you can receive in one year. 

You should weigh all the costs if you're the insurance purchaser. 

Employers pay the premiums on many dental plans as an employee benefit. If, however, you're paying the premiums yourself, you need to add that cost to your other out-of-pocket costs for a true picture of what you're actually spending on dental care. It's possible a self-paying policy won't save you money or could even increase what you might otherwise pay for dental care. 

Your policy might limit your options. 

Most plans pay for the “basics”: routine cleanings and checkups, repairs and some restorations. They may or may not pay for orthodontics, certain dental materials for fillings or crowns or restorations like dental implants. Some plans could require you to see a dentist in their network, which may not include the one you prefer. It's important to find out any limitations in your policy and factor them into your cost vs. benefits evaluation. 

If you’re considering an HMO, be aware that many of the better dentists don’t participate.  

HMOs are generally "capitation plans" that will pay the dentist a certain amount of money based on the number of patients the dentist oversees, pretty much no matter what service is offered, and even if no treatment is given.  While this might prevent theoretical up-selling, it may also incentivize lack of any treatment.  Cost-savings incentives, therefore, might lead to inferior treatment. Many of the dentists who participate are just starting out and are trying to start a practice, or are semi-retired and want a little extra income. 

You can ask your dentist for help managing your dental care costs. 

While your plan may seem to you to be written in a “foreign language,” your dentist's staff works with it and other policies on a daily basis. They may be able to help you figure out the best approach for a procedure within your policy or help you arrange payments and financing that fit your family budget.

If you would like more information on managing costs, talk to Dr. Basil. 

Keep smiling,

 

Dr. Elzbieta W. Basil, DMD is a private practice dentist with offices in West Hartford Center and Downtown New Britain, Connecticut.  She is a Clinical Instructor at the UConn School of Dental Medicine, and has won several awards naming her regional “Best Dentist” and “Top Dentist.” She is an active member of the Connecticut State Dental Association and the American Dental Association. Tel: 860-561-2121