How to Get the Most From Dental Insurance

Dental insurance plans vary greatly. Some pay only for routine care like cleaning and exams. Others will also cover more expensive work, and still others operate like "catastrophic" medical plans, paying only when a high deductible is met. Understanding your plan provisions and how they work will help make sure you get the most from your coverage.

Instructions

1. Know your benefits. Most plans cover exams twice a year, but it might be once every six months. Although it sounds the same, it is not. Going a few days before the six months are up could mean the services are not covered.

2. Use your benefits. Going for regular routine care keeps your teeth in better condition. This may help avoid more costly procedures that may be only partially covered, or not at all.

3. Choose a participating dentist. Some dental insurance requires you use only contracted dentists, or they may give better benefits if you use an in-network dentist. You can search for a participating dentist near you at the insurance company's web site.

4. Schedule appointments ahead of time. It can take a few months to get an appointment with some dentists, so do not wait until the last minute.

5. Request a pre-determination of benefits before having major work (such as crowns, bridges and other restorative work) done. Your dentist may be recommending expensive cosmetic procedures or other work that your dental insurance excludes. Ask the dentist to submit a treatment plan to the insurance company, and you will know exactly what it will cover and how much it will pay in advance.

6. Time expensive work to maximize reimbursements. If you have a deductible or out-of-pocket limit, don't put off work until the next year when you will have to start all over again.

7. Use your Healthcare Reimbursement (or Flexible Spending) Account, if you have one. These accounts, available through many employers, allow you to put aside money tax free that you can then use to pay medical expenses. Many people do not know that the money can also be used for dental expenses not covered by insurance.

Tips & Warnings

• Preferred or participating dentists will often discount their fees even for procedures that are not covered by dental insurance, such as those exceeding the annual maximum or cosmetic procedures.

• Do not make assumptions about what is covered by your dental insurance plan. Call the insurer with any questions you have.

References

• United Concordia: Make the Most of Your Benefits