Can I combine dental and health insurance plans?
Yes, many health insurance companies give you the option to combine both your health insurance and dental insurance into one plan. Having both with one insurance company allows you to maintain consistency with your insurance providers.
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It also makes claims and changes easier as well when you have both with one provider. Additional, you may be able to save by doing so.
What does a dental plan cover?
In most cases, a dental insurance plan that is combined with a health insurance plan covers basic and preventative care. This includes:
- Regular six-month check-up
- X-rays including bitewings
- Teeth cleanings for both children and adults
Some of the services covered by dental insurance plans only cover a portion of the cost. For example, some dental insurance companies will pay for half of the cost of a regular check up, and you are responsible for paying the remaining amount.
There are some dental plans that do not cover preventative care. In these cases, you will have to pay for the costs yourself or find a supplemental insurance program that can help with the payments. Be sure to speak to your dental insurance company about the fees and costs associated with the plan as well as what are is covered with your insurance.
Should I get dental coverage?
If you have dental coverage offered to you through your health insurance plan, you should consider signing up for coverage even if you have to contribute a small amount towards the plan. This is because dental work can become extremely expensive, and if you do not have coverage, you will either be responsible for paying the amount yourself or risk not having the dental work done.
Most health insurance plans do not cover any type of dental care, so you cannot rely on your health insurance coverage to help defray some of the dental costs. In the majority of the cases, your monthly or annual premium for dental coverage will work out to less than $1 a day.
What are the types of dental care than I might need?
There are four basic categories of dental care that your dental insurance plan might cover:
The first is preventative and diagnostic. This includes:
- Cleanings, usually two per year
- Fluoride for children ages 19 and under
- Tooth sealants for children up to age 16
- Two bitewing x-rays per year
- One full mouth x-ray every three years
- Emergency treatment to help relieve pain
The second category is basic restorative coverage, which is for fillings, extractions, periodontics, and endodontics. These services include:
- Filings, either white or silver
- Oral surgery including extractions and impacted tooth removal
- Root canals
- All different types of surgery including follow up care from a surgery for up to two years
Major restorative is the third category, and these services include care for prosthodontics, including crowns, bridges, and dentures. Some insurance companies will cover both partial dentures and complete dentures, and will take care of removing real teeth and replacing with false teeth. In most cases, these services are only covered once every three or five years due to the high costs associated with them.
Finally, the last category of service that a dental insurance plan may cover is orthodontia. This is primarily for children getting braces, including the initial diagnosis, monthly treatments, any necessary follow up and more. Usually, there is a lifetime maximum per patient with this type of coverage, meaning that children or dependents can only get braces once.
How do I know what dental care will cost with my insurance coverage?
First, you should speak to the insurance company and get a list of approved treatments, payment amounts, and co-payments, if any. In the case of any extensive treatment such as braces or a surgery, it is highly recommended that you receive a predetermination of benefits. This document produced by your dental insurance company explains what charges will be covered so you can plan for any out-of-pocket costs.
To receive a predetermination of benefits form, speak to your dentist and ask for details of the care you or your family member is planning to get. Once you have this information, you can forward it on to your dental insurance company.
Although health and dental insurance rarely cross over, in the case of a surgery, there may be some overlap. This is because if your dental surgery results in an overnight hospital stay, your health insurance will cover the costs seamlessly. This is another benefit of having your health and dental insurance with the same company.
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