Dental insurance is a kind of insurance which is designed so as to pay a portion of the costs which are associated with the dental care. The dental insurance plans change widely and one should be aware of how their plan is designed as those can notably affect the coverage of the plan and the extra expenses. The individual features of a plan differ from one to another. But there are a few things which you must understand while getting a dental insurance plan.
Annual Limitation of Benefits
The dental insurance plan might limit the benefits that you are going to receive by the amount you receive each year as well as the number of procedures provided each year. This is done so as to contain the cost. In most of the cases, especially if you have been getting preventive care regularly, all the limitations would still allow for an adequate coverage. Dental insurance that covers implants is a great way to save some money. By knowing what and how much you would receive from your plan, you can plan your treatment accordingly.
Predetermination of the Costs
Some of the dental insurance plans encourage you as well as your dentists to submit a proposal for the treatment to the administrator of the plan before actually receiving the treatment. After reviewing the plan administrator may or may not determine the eligibility time period, the eligibility of the patient, the services to be covered, the maximum limitation and the co-payment required by the patient. Some of the plans might require predetermination for the treatment which exceeds a specified amount. This process is also referred to as precertification, preauthorization, prior authorization or pretreatment review.
Peer Review for any sort of Dispute Resolution
Many of the dental insurance plans offer a mechanism for the peer review which would help in solving the disputes between the patients, third parties or dentists which would eliminate most of the courtly cases. The process of peer review is established so as to ensure that there is absolute fairness and consideration of the individual cases. A thorough record examination, procedures of the treatment and its results are also possible with the help of peer review. It is often seen that most of the disputes can be satisfactorily resolved for all the parties through peer review.
Key features to Consider When Choosing a Dental Plan
While choosing a dental plan, you must consider the following features.
- If the plan gives you enough freedom to choose the dentist of your choice. In case it is a restricted panel, check if your dentist is present on the panel.
- If the plan covers preventive, diagnostic and emergency services. And if yes, to what extent.
- Checking what major dental care is covered in the plan and the percentage that you would be required to pay.
- Limitations of the plan as well as its exclusions.
While there are several benefits of dental insurance that covers implants, you must check if the plan actually benefits you in the long run and how much money you would actually be able to save.