Dental Insurance 101. What you don’t know could you hurt you and your wallet
Dental insurance is a fabulous benefit that makes it easier for people to get regular checkups and cleanings and, in a lot of cases, avoid major problems. What can sour people a little on their dental insurance is when it comes time for major work and the reality of what is covered and, more importantly, what is not, hits home.
“The average dental benefit offers about $1,500 worth of coverage. While that can cover your cleanings and a routine filling, what can be tricky is that not all treatments are covered 100% under that $1,500 benefit”, said Dr. Richard E. Wolfert, a dentist whose practice is located at 1121 in South Weymouth. “A good example of that are composite fillings versus amalgam fillings.”
Continues Wolfert, “Many patients prefer composite fillings, which are white, to the more traditional amalgam fillings, which have that silver, metallic look. Composite fillings are a little more expensive than amalgam fillings. Consequently, some dental plans make you pay more out of pocket for composite fillings than for the conventional silver fillings.”
To avoid surprises at bill time, many dentists, like Dr. Wolfert, offer what is called a pre-treatment estimate of services for work that goes beyond the standard treatments. This involves communicating with the patient’s insurance provider in advance to get an estimate of out of pocket expense prior to treatment. Typically, a pre-treatment estimate will take a few days up to a few weeks depending on the dental insurance provider, which can sometimes delay treatment.
Communicating with their insurance company is not something patients typically do—until bill time. That’s why Wolfert recommends patients have their dentist review their benefits prior to an appointment if they are unsure of their coverage.
Said Wolfert, “Our front desk staffers have a general understanding of insurance benefits, but each company is different. Most times it is necessary to review your insurance benefit by using our special software to decipher exactly what your benefits cover.”
Wolfert also recommends taking care of any dental work prior to the holidays and the end of the calendar year. Adds Wolfert, “It’s now November and if you need dental work and you haven’t used up your benefit, you should schedule that works as soon possible. The best idea is to maximize your benefit this year (2012) so that you preserve your next year’s benefit (2013) for treatments you may require then.”
“Most companies prefer you don’t use that philosophy, because if you don’t use your benefit, you lose it. It is not generally tacked on to the following years benefit. Although there are some companies now that do allow you to roll a percentage of the benefit over into the following year, most do not.” In other word “USE it or LOSE it!”
Dr. Wolfert’s practice is located at 1121 Main Street in South Weymouth, Massachusetts, and accepts most insurance plans. They also accept payment from most insurance companies, including Blue Cross/Blue Shield and Delta Dental.
For more information on the Toothboss, visit Dr. Wolfert’s website at www.toothboss.com or call 781-335-0604 to schedule a consultation.
About The Toothboss
The Toothboss offers: comprehensive examinations (written treatment and treatment plan provided); cosmetics; crowns, bridges and tooth-colored restorations; partial and full dentures; periodontics (early cases treated); oral surgery; restoration of conventional and small diameter implants; and emergency services (24-hour emergency phone number available).
The Toothboss accepts most insurance plans. They also accept payment from most indemnity plans, including Blue Cross/Blue Shield and Delta Dental. They also accept all major credit cards and have arranged payment plans through CareCredit.
To schedule an initial consultation, please call 781-335-0604. For more information, visit www.toothboss.com.