Dental Insurance…Which Option Should I Choose?

It’s that time of year again where your Human Resources person at your company is telling you that you need to renew your benefits.  So what exactly does that mean to you?  Be very careful when looking at your options, because remember that dental insurance works the reverse of medical insurance.  So what does that mean?  Let’s break down your benefits.

What Does “Dental Insurance Works the Reverse of Medical Insurance” Mean?

When I go to see my medical doctor for a cold or to have a procedure done, I usually get a bill for the entire amount because of my deductible.  I must meet my $1000 deductible, for example, BEFORE my insurance will pay anything to my medical provider; meaning I get stuck with 100% of the bill.  I know I have gone through many a year where my medical insurance company never even paid anything to my doctor because I only went once or twice and never met my deductible. Frustrating!  The biggest upside with dental insurance, I guess if there is one, is that it typically pays towards my cleanings and procedures (unless I’m told I have a waiting period) right away when my plan year is effective.  It also pays for all or majority of my cleanings and usually 50% or more if I need any work done; I don’t have to meet a large deductible first! Awesome right?

Making Good Plan Choices

If you’re fortunate, your company might give you more than one option for benefit levels for your dental insurance.  You have a choice between a $1000 plan vs. a $1500 plan, do you REALLY need the $1500 plan?  The first thing you should do is pencil out the difference in premium you will pay per month to get that additional $500 in benefits and how many people there are in your household that will benefit from that extra $500/year per person.  If it isn’t a significant difference, then opt for the $1500 plan; here’s why. 

Let’s say that you choose the $1000 plan and you will read information that is given to you by your insurance company that says that “you get two free cleanings each year,” that’s correct as long as you have benefits available.  So how do you really know what you will use in benefits each year? The average adult that comes in for two cleanings every year will use up just shy of $500 in benefits, leaving $500 left for any unforeseen restorative procedures that are needed.  Now what happens when your doctor says that you are going to need a crown and your plan covers 50% of your crown?  Doing the math, you only have $500 of benefits left so you won’t even get 50% coverage because you will be out of benefits. That increases your out of pocket expenses by $200-$300 or more if you needed other work as well.  Now if you would have chosen the $1500 plan, you would likely get that 50% coverage for your crown and have a small amount left in case you have a cavity that needs to be filled. 

Use all of your benefits!

Every year I see it happen over and over, patients forget to get that second cleaning or that crown that was diagnosed earlier in the year carries over to the next year because for whatever the reason, the patient decided to wait leaving dental benefits in the pockets of the dental insurance companies and you with nothing.  Those benefits don’t carry over and you lose any amount you didn’t use up earlier in the year!  Don’t let that happen, that’s exactly what the insurance company wants you to do, saving them millions of dollars each year!

We never really know how much we will use in benefits each year, my crystal ball just doesn’t always work for me when I ask what will happen, but again if it makes sense to opt for the larger plan do so! I know some of this may have been confusing but what we would really like to you know is that we are here to help you make good decisions about your dental insurance.  For some of you, it might not even make sense to pay for dental insurance. Let us help you look at your options and your dental history.  We don’t charge for it, just pop in the office during our regular business hours and either I or Office Manager Shelly would be happy to look things over and help you make those tough benefit decisions.

Good luck and stay happy and healthy…can you believe 2018 is right around the corner??   

Stephanie Kraniak, Insurance Coordinator

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Dental Insurance…Which Option Should I Choose?