Get the Most Out of Your Dental Insurance Benefits This Year

Did the year 2021 lapse without you maximizing your kids’ dental insurance benefits for your family? As parents, we pay significant attention to our medical insurance coverage while we typically maximize those benefits simply by living out our normal lives, yet dental insurance benefits often are underutilized. That is in part due to the fact that unless one of your kids is complaining about a toothache or has braces, it simply isn’t used at the same frequency of our medical insurance but also in part for the reason that dental insurance costs are a fraction of the healthcare monthly payment or even a modest rider to the plan. It literally takes up less space in your brain as well as your wallet.

Nevertheless, dental health, when unhealthy, can be costly. Take some time to review your coverage, do you know what type of plan you have? Do you have a dental insurance plan?

Types of Pediatric Dental Insurance Plans

The adult world is full of tall letter acronyms and jargon that can be intimidating. Consequently, often parents don’t actually know what type of dental plan they have. Here’s a quick breakdown of the three common types of dental plans:

PPO Preferred Provider Organization – If your dental insurance is a PPO, then that means your plan covers dental services at fixed costs within a specific network of dentists, aka, preferred provider organization. Before you visit a pediatric dentist, check to be sure they are part of your PPO. If they aren’t, prepare yourself to pay out of pocket.

DHMO Dental Health Maintenance Organization – This is a dental HMO, which means the dentists in your network receive a flat monthly fee for specified covered dental services, whether you utilize them or not. Not all covered dental services in a DHMO are free, check for which services will require a co-pay.

Discount Dental Plan or Referral Dental Plan – This is exactly what it sounds like, a discount card. The dentists in the network agree to a discounted rate for their dental services, usually, this includes cosmetic services as well. For these types of plans, there are no insurance submissions or requests for authorizations; you pay for any and all services at a discounted rate.

Tips for Selecting a Dental Health Insurance Plan

Open enrollment for employee medical and dental healthcare plans typically takes place in October, however for those of you starting a new job, or without any dental care coverage currently, read this thoroughly before you sign up! Here are a few tips to help you navigate how to select the best dental care coverage for you and your family.

1. How Big is the Plan Network? Take a look at the list of preferred providers. If you’re looking for a new pediatric dentist, we recommend that you ask if they are a preferred provider, part of the DHMO, or contracted members of your discount plan. The idiom “the bigger, the better”, doesn’t always apply for dental networks, but if it’s a meager one you sure want to know if there’s a pediatric dentist near you that’s part of it.

2. Does Your Current Dentist or Pediatric Dentist Have an Opinion About Providers? Ask the staff at your current pediatric dentist if they have any opinions about dental care providers. The staff who manage the claims just might steer you away from a difficult provider or a plan that they’ve seen other parents dissatisfied with.

3. How is the Network Discount Rate Calculated? Discount dental plans or referral dental plans are popular on the grounds that they are generally straightforward and often even cover cosmetic services. Nevertheless, it is important to learn not only the discount rate, but exactly how it is calculated (you should be applied to any dental plan that indicates a discount). If the dental plan states it provides a dental discount of 23% across the board for dental services, you should know if that means a 23% discount of the nationwide average, state average, or county average.

4. Are Your Kids Covered in the Dental Insurance Plan? We know we’re biased here by virtue of our profession. Regardless of this fact, if you have kids or are planning to have kids, this is important! Preventative dental care is integral to your children’s overall health and well-being. Preventative care isn’t only the twice per day brushing/flossing routines at home; it includes the biannual professional cleanings, the checkups, and the education.

5. What is the Maximum Annual Amount for the Plan? You can expect the annual maximum amount your plan will pay to be between $1,000 to $1,500, per covered person. Hence, question number four is important! If each person isn’t allotted a separate maximum annual amount, but instead the amount is for all covered parties, be wary of any amount that is lower than the equivalent of at least $1,000 per person.

6. Does the Plan Have a Least Expensive Alternative Treatment (LEAT) Clause? A straightforward example of this would be when your child needs a filling, will the plan cover the filling to be composite (i.e. tooth-colored) or does it invoke a LEAT clause which would only pay for an amalgam filling (i.e. metallic, therefore, cheaper).

We Accept Most Dental Insurance Plans at Utah Pediatric Dentists

We work with and accept most dental insurance plans and are part of several PPOs. Even if your provider isn’t on this list, give us a call to double-check that your provider isn’t a new addition:

• Aetna

• Assurant/Sun Life Financial

• Ameritas

• Allegiance

• Anthem BCBS

• Regence BCBS

• BCBS Federal

• Blue Cross of Illinois (Blue Care)

• Blue Cross of Michigan (Blue Dental)

• Carrington

• Cigna

• Dental Select

• DMBA

• Dentist Direct/Direct Care Administrators

• Dentamax

• Delta Dental

• EMI

• GEHA – Connection Dental Network

• Guardian

• Humana – Connection Dental Network

• Life Map

• Lincoln Financial Group/Lincoln Dental Connect

• Metlife

• Traditional Medicaid

• Medicaid Premier Access

• Premier Access PPO

• Premier Access Chip

• PEHP

• Principle – EMI Network

• Standard Life Insurance/Reliance Standard

• Select Health

• Utah Sheet Metal/JAS/Southwest Service Administrators

• United Concordia PPO

• United Concordia Tricare/Active Duty

• United Healthcare – GEHA/Connection Dental Network

Make an Appointment for Your Kids Today!

Don’t wait to start maximizing your dental plan when it comes to your kids. If you have any questions at all about your dental health plan coverage, let us know! We’re in the business of seeing kids smile, so kick off the year by prioritizing their dental health.