Trying
to decipher the nuances of different dental insurance plans can be difficult. There
a so many carriers and then there are different plans within those carriers
that it can be overwhelming. Our goal today is to look at some of the common
myths of dental insurance and what you actually need to know.
Myth: The insurance company will pay the
fees that the dentist charges.
Fact: It has been the experience of many
dentists that some insurance companies tell their customers that “fees are
above the usual customary rate” instead of telling them that the “insurance
benefits are low.” A good thing to remember is that you get back only what your
employer puts in minus the profits of the insurance company.
Myth: The new alternative insurance
plans are the same as the traditional plans.
Fact: The new plans referred to as PPO’s
or DMO’s are simply discount plans. All these type of plans require the dentist
to severely discount their fees nearly 50%. In order to take these plans and
remain profitable business, the dentist must choose less expensive or faster options
that may not provide the same long term results as when they are not restricted
by the insurance company.
Myth: Once you reach your yearly deductible,
everything else is free.
Fact: Dental insurance does not act the
same way as medical insurance. It acts more like a coupon. It typically does
not pay for the entire product or service and only pays a vague percentage. And
once you have reached your yearly maximum, it no longer pays on anything.
Myth: The insurance will pay for the
dental work because I need it.
Fact: Not all procedures that are needed
will always be covered by your policy. When your company selects a plan, it is
decided which procedures may or may not be covered. The lack of coverage by
your insurance company does not mean it is not needed, it just means your plan
has chosen not to cover the procedure.
All
of this can obviously be very confusing and even frustrating. If you have
questions or concerns on which dental plan may be best for you and your family,
please feel free to contact us and we can hopefully help you in deciding which
one is best for you.
Brown and Kupper DDS, Inc.
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