As you can imagine, we deal quite a bit with dental insurance. We are by no means experts, but here are some areas that you might not be aware of with your dental insurance policy, as well.
The following examples typically apply to cases where you’re buying your own policy and not using one provided by an employer. A bit of rarity in the past, these cases are becoming more common with the passage of Obamacare.
Please note that we are not insurance experts, nor do we sell insurance. We just want to bring to light some issues that some issues we’ve seen affecting patients who buy their own insurance.
Tip #1 – Make Sure You Understand the Waiting Period
Most employer insurance policies don’t have a “waiting period,” but we see it quite often with an individual policy.
When you buy your own policy, it typically includes a waiting period. Here’s how it works: After you sign up for insurance and pay your premium, the waiting period begins. During this time, the insurance won’t cover any preventative services, including routine cleaning and exams.
These waiting periods can sometimes stretch to six months, so you’ll want to plan accordingly. Waiting periods also exist for restorative and major work. They can stretch as long as 12 months.
Be sure to check your policy and be clear on exactly how long the waiting period will be if one applies to the policy. You can also choose a plan that does not have a waiting period so be sure to explore all of your options.
Tip #2 – Review Your Replacement Clause
If you have work done within a specified timeframe on your teeth, some policies have a Replacement Clause that states there will not be coverage to have it replaced within a certain number of years. Again, not all policies have a replacement clause so be sure to explore the options.
Consider how a Replacement Clause might work with crowns. Our crowns typically last far more than five years. To ensure that all dentists are doing that same kind of high-quality work and to make sure patients take care of their teeth, some insurance policies may specify that if a crown needs to be replaced and is less than five years, it won’t be covered.
That’s just one example of how the Replacement Clause typically works. Be sure to read your policy carefully to understand how the Replacement Clause might affect you.
Tip #3 – Understand Your Maximum and What It Means For You
Premiums are tough for everyone. To save cash, you may be considering a policy with a smaller monthly premium.
We have no problem with this strategy, just be sure that you understand what is covered by most dental offices. For example, if you sign up for dental coverage of $500, contact your dentist’s office and ask how much coverage that would provide for you.
Insurance is all about making sure you’re covered for the tough times, and in the cases you need some extensive work. Talk to your dentist (I’m happy to have the discussion with you) about what types of protection would be ideal for your family.