Many people find dental insurance plans confusing to navigate simply because it doesn’t work exactly the same as health insurance plans. While they are similar in certain ways, they have plenty of differences. Everyone wants to maximize their benefits, but it is difficult to do when you don’t know exactly how it works. Continue reading to learn some helpful tips so you can grasp a better understanding of dental insurance.
Know Your Particular Plan
Your dental insurance plan is unique to use. So, when you understand what exactly it covers, you will feel more confident to seek the care that you need and want. When you go to the dental office, your insurance company pays a percentage that is based on the price level set for each treatment. You should know what this allowable amount is before you commit to any treatments so you know what you will be responsible for afterwards.
Choose Your Own Provider
PPO stands for “preferred provider organization.” This means that you get to choose your own dental provider, and it is not your insurance company’s job to dictate who you should go to for care. However, you will definitely want to check the differences of coverage between dental providers in order to make the best possible choice. You need to weigh the pros and cons in order to determine which one works best for your individual needs.
Know What “Out of Network” Means
When you think “out of network,” you may think that you’re out of luck. However, this is not necessarily the case. Sometimes this may mean that your insurance plan does not cover any treatments at the practice, but other times it just means that the amount that is covered reduces, but coverage is still available to help you get affordable care.
Understand That You Are the Customer
Your dental provider isn’t a customer of your insurance company – you are! If you are ever in a situation where you need to pay your provider in full, your insurance company will reimburse you directly in a matter of weeks. They are much faster to reimburse you than the dental practice. Fortunately, you have a helpful administrative team to give you a hand in figuring this out, but it is always best that you verify your own benefits so you know what you can expect.
Dental insurance can be confusing, but by gaining a better understand of how it works, you will have a much easier time maximizing your benefits and getting the essential dental care you and your family need.
About the Author
Dr. Arthur Volker earned his Doctor of Dental Surgery from Columbia University’s School of Dental and Oral Surgery. He is a member of numerous professional organizations including the American Dental Association and the Academy of General Dentistry. DentCare Dental Center is in-network with many popular PPO dental insurance providers, and the team is happy to work with many out-of-network policies as well. For more information on dental insurance or to schedule an appointment at Dr. Volker’s office in Sunnyside, visit his website or call (718) 937-6750.