Healthcare and health insurance is still a hot topic in the news. Every day, we deal with dental insurance. St. Petersburg patients are asking about how their dental insurance may be affected and what it covers.
Obamacare’s impact on dental insurance
Currently, most families with dental insurance acquire it through their employer as a separate plan form their health insurance plan. In general Obamacare (Patient Protection and Affordable Care Act) mandates that companies offer employees dental care for youths. Specifically mentioned in the law is the requirement to provide health care coverage that includes “pediatric services, including oral and vision care.” This means health care packages offered by employers will need to include pediatric dental services. Many families will need to decide whether to remove their children from the separate dental insurance policies and move them to the benefits provided by the health insurance package being offered. There is no mention of any changes to adult dental health care coverage or insurance requirements.
What does dental insurance cover?
There are many variations to dental insurance. In addition, dental offices interpret procedures differently when applied to dental insurance plans. Some may see a procedure as part of a routine cleaning, while others may see the same procedure as outside of that category and require an additional payment.
Preventive care, like cleanings and annual x-rays, are usually covered in most dental insurance plans. This category also includes checkups, fluoride treatments. Basic procedures are different from preventive care because they include fixing problems specific to your situation. In this category are things like pulling teeth, filling cavities and fixing chipped teeth. These procedures usually require co-pays or percentages of usual fees specific to the procedures.
If you need major procedures, make sure you understand your annual limits on your dental insurance. Policies vary, but some cover a certain amount of expense per year. Timing your procedures to take advantage of these limits may be a smart move on your part.
Cosmetic procedures are more frequently not covered by dental insurance. In general, you should feel free to have a conversation with your dentist’s front office to clarify what is, and is not, covered by your dental insurance regardless of what procedures you are facing. We will do our very best to maximize your reimbursement from you insurance company and minimize your out of pocket expense.
Should I stay In-Network?
Many insurance policies are written in such a way that is very confusing. It often seems as though it is highly advantageous for patients to go only to ‘in-network’ providers. Most of our patients who have dental insurance come to our office ‘out-of-network.’ Many times we find that there is very little financial difference in out of pockets costs when patients choose our office ‘out-of-network.’ We have found that being out of network for most plans, we are not restricted by the insurance companies’ rules and can provide patients with the best care possible. Always choose your dentist based on expertise and how they treat patients, not because they were ‘on your list’. It is very likely that your dental work will be of higher quality and your experience in the office will be more pleasant and comfortable.
What if I don’t have insurance?
Don’t worry. We do everything we can to make dental treatment as comfortable and affordable as possible. Many of our patients do not have dental insurance. It is true, insurance can help offset some of the costs of treatment, but policies are written with many limitations and exclusions and often help very little when major treatment is needed.
Our friendly dedicated staff greets you by name and with a warm smile. Dr. Maher Rashid, Dr. Murad Rashid, and our entire team of experienced dental professionals are committed to treating you with respect, personal attention and a higher level of care that comes from decades of combined dental experience. At Dolphin Dental Group, we take the time to listen because there is simply no better way to ensure you get the gentle care and beautiful smile you deserve. We take care to make our dentistry practice the best it can be. We serve the Seminole, St. Petersburg, and Largo, Florida areas.
We would like to be your St. Petersburg, FL dentist office. Please Contact Us to let us show you how much we care about our patients.
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