What is it?
Dental insurance helps cover preventative dental care—such as exams and cleanings—and corrective care—such as fillings, root canals, and crowns. A dental policy will not cover cosmetic procedures like teeth bleaching.
Learn more:
The American Association of Endodontists (AAE)
aae.org
The American Dental Association (ADA)
ada.org
Wikipedia: Dental Insurance
Why do I need it?
Dental hygiene is an essential factor for maintaining your general health. Benefits are offered by employers for a variety of reasons because they make monetary sense. Employees are often absent or perform poorly at work due to dental disease or problems. And since all bosses know that time equals money, a good dental plan can help both recruit and retain valuable employees.
Learn more:
The American Dental Association (ADA)
ada.org
Centers for Disease Control and Prevention (CDC)
cdc.gov
How does it work?
There are two common types of insurance policies: Preferred Provider Organization (PPO) and Health Maintenance Organization (HMO). With PPOs, the member companies negotiate the fees with dentists in exchange for the dentist being added to a group of "preferred" providers. Most PPOs have a $50 to $100 deductible and a yearly maximum ($1000 is typical) of available funds for care. HMOs work on the assumption that you can avoid medical problems in the future by "maintaining" the state of your health now. HMOs usually offer broader policies and lower (65 to 70 cents per dollar) expenses than PPOs, but you are limited to the HMO's providers.
Learn more:
The American Association of Endodontists (AAE)
aae.org
Who provides it?
Almost all dental insurance companies provide no-test insurance.
Depending on the state you live in, you may be able to get a policy
directly from the insurance company. There are also "buyers' clubs" or
"referral plans," in which the individual policy holder pays monthly
dues to a third party in exchange foraccess a group of dentists at
discounted fees. Payment is made from the patient directly to the
dentist. The role of the third party is only to help get a policy and does not
provide payment to any dentist.
Learn more:
The American Dental Association (ADA)
ada.org
What if I’ve been turned down before or have health issues?
First of all, don’t panic. Ask the insurance provider for details regarding your decline. This information must be provided by law. Some states will send this information directly to you, while others mail these details to your doctor. When you know the reason for your denial, visit your doctor to determine if you have health problems. Quite often, insurance applications save lives by informing the applicant of a serious medical problem of which he/she was previously unaware.
If you’ve been declined by an insurance company:
- Obtain a copy of the claim form.
- If you’re working with an agent, inform him/her in advance of any health conditions/prior situations.
- Errors do occur, so consider challenging them or requesting reconsideration.
- Ensure the application says whether you qualify before you apply.
- Make sure you get some kind of coverage as soon as possible
- Ensure you’re not applying to a provider that will refuse your illnesses.
- Learn the details of the policy to see if it is right for you.
- Always read the fine print and ask questions if anything is unclear.
Learn more:
The American Dental Association (ADA)
ada.org
