Do you Know Your Dental Insurance?

It’s getting to be that time of year when most employers choose a new dental insurance company. Before signing up with that insurance be sure you read the fine print to understand what you are purchasing.

Here are 6 questions to ask your Human Resources Department about your dental insurance.

  1. What is the percentage coverage for preventative, basic, and major?
    1. Preventative: dental cleanings, exams, x-rays
    2. Basic: fillings and periodontal cleanings
    3. Major: crowns, dentures, and implants
  2. Are there any waiting periods for basic and major?
    1. Sometimes there is a 6 month waiting period for basic and a 12 month wait for major.
  3. What is a yearly maximum?
    1. The yearly maximum is an amount of money each person receives to use for the year. If it is not all used in the year, it usually will not roll over to the next year. However, there are a few insurance companies that do roll over the unused portion of the yearly max.
  4. What are the frequencies on dental cleanings, exams, and x-rays?
    1. Usually the frequency on dental cleanings is 2 cleanings anytime in a calendar year, or it could be 6 months and a day apart. Some employers have chosen to allow their employees to have more than 2 dental cleanings a years, for example, Exxon Mobil.
    2. However, there are a few dental insurance companies that allow for a woman who is pregnant to have an extra dental cleaning.
  5. Is there a Missing Tooth Clause?
    1. A missing tooth clause describes a situation on in which benefits are not payable to replace a tooth that was extracted prior to having dental coverage.
  6. What is the Replacement clause on crowns, bridges, and dentures?
    1. On average the replacement clause for crowns, bridges, and dentures is 5 years. This means that if you have a crown or bridge and it breaks the insurance will pay to replace it if it is over 5 years old. This holds true for the dentures if the denture has to be replaced and it is unrepairable.

Dental insurance plans vary widely. You should know how your plan is designed and all its meanings. After you’ve investigated the plan you should have a total understanding of the plan, and how it works.