Dr. Dawn: Insurance 101, Use It Or Loose It

By Dr. Dawn

Congratulations! You have dental insurance! If you have dental insurance, you are fortunate than most dental patients. Having insurance benefits can really help one to afford ,more comfortably, needed dental treatment. But beware!   There are certain things that you should know about your dental insurance.

1. Dental insurance is like a coupon: Once you give the cashier your coupon, he or she makes a price adjustment and then they let you know what your balance is.
   • There is, more often than not, a co-payment due for dental services, especially if your treatment goes beyond an examination, cleaning, and x-rays.
   • Most dental offices have financing and payment plan options to make the copayment less intimidating.

2. The terms “lifetime” and “maximum” do not mean that your insurance benefits are unlimited.
   • There is usually a limit on the dollar amount that your insurance company is willing to pay every year. And every year this dollar amounts replenishes itself, usually January 1^st of each year.
   • “Lifetime” and “maximum” are terms that usually apply to orthodontic treatment (braces) which means (If your insurance company does cover orthodontic treatment, it will offer a “maximum” amount once during your “lifetime.”)

3. Dental insurance is not “all inclusive.”
   • Most plans do not cover services such as bleaching and other cosmetic procedures

4. What is a deductible, you ask?
   • A deductible is a fee that the patient pays every year that the patient or the patient’s insured family member is in active treatment  (this fee is established by the insurance company and can range from $50 to $250 on average. It can be thought of as a yearly membership fee when using dental insurance benefits).

*Note: Co pays are payments that are due from the patient for each dental service received and deductibles are a once yearly fee that the patient is required to pay in addition to any copayments due for active treatment.

5. If you don’t use them, you loose them.

If you don’t utilize your insurance benefits for the year, you will loose them. Your benefits will not “roll over” and do not accumulate. Most dental plans renew January 1^st of every year.

Don’t allow a lack of knowledge about your dental insurance limit your seeking professional dental care. Knowledge is power.

Dr. Dawn, As one of only a few African-American female Dentists in the Country and the World, “Dr. Dawn” Jones holds two Bachelors of Arts Degrees from North Carolina Central University and a Doctorate of Dental Medicine from the University of Medicine and Dentistry of New Jersey. Dr. Dawn has trained in the Differential Straight Arch Technique, an orthodontic discipline that encourages continuous light force(s) to generate optimum results