What does my individual dental plan cover? This seems like such a simple question. Its probably the most common question asked in the world of an individual dental plan or insurance. However it is also probably the most difficult question to find a complete answer to. Really, what do you actually mean by that question? Look at some of the most common meanings of that loaded question. Then attempt to uncover some of the real answers.
Perhaps you are asking how many procedures does a particular plan cover. An individual dental plan will usually have some type of fee schedule available, either a complete fee schedule or a sample. This may be an important thing to look at when comparing coverage on plans. Sometimes a fee schedule may have hundreds of different procedures however the savings for each one is not very high. However other plans may have about eighty different procedures and have a huge savings on each one. This is only one of the aspects of dentistry coverage.
The next question you may be asking is, "what costs does this plan cover?" There are two parts to the answer to this question. You may also find individual dental plans sometimes that do not even operate off a percentage basis. The whole idea behind a fee schedule is that the actual price of a procedure is contracted with the dentists, which means their regular prices go out the window. This allows the member on the plan a sense of security knowing that they won't double the normal price knowing that they will have to give a 50% discount. Secondly, for some specific procedures in a plan, cosmetic procedures for example, are set on a percentage basis. This part of the plan's coverage will normally be highlighted on the bottom of the fee schedule provided.
Next you may be wondering, "what can I get for free using this plan?" If your accustomed to insurance policies that provide a free cleaning two times a year, this question would be expected. However most individual dental plans have everything, including cleanings, simply offered at a discounted price. Because the savings on these plans are at the expense of the dentist, there is no way any dentist will offer a free cleaning knowing that they will be offering the rest of their services at half the normal cost.
Lastly your real question may be, "How much does the plan pay and what do I have to pay?" As expressed in the previous section, the savings actually is found at the expense of the dentist. The plan doesn't actually They have agreed to charge patients the prices according to the fee schedule of the individual dental plan that they are on. This does lose the dentist some profit on each procedure however the plans to bring in extra income when their chairs may have been empty otherwise. In short, the plan doesn't pay anything to the dentist. This is another reason why an individual dental plan is often much more affordable than your typical insurance.
What does this plan cover? This is a broad question with many different answers, however once you can come up with an answer to all of its meanings you should have a total understanding of the plan and its advantages to your wallet. When you are investigating an individual dental plan, call the sales office and ask the questions above and find out if it really is a helpful plan for you.