How well do you know your dental insurance plan?

Did you know that each dental insurance plan can vary depending on the employer who has elected the plan on your behalf?  Each individual employer negotiates coverage and benefits on the employees’ behalf and believe me, employers work very hard to get the best coverage at the best price to help keep their employees healthy.  Unfortunately, and no secret being revealed here, health care costs are often difficult to manage.  There are ways you can help take matters into your own hands!

First, always keep your scheduled appointments!  Believe it or not, failing to show up for an appointment or cancelling an appointment the day before increases costs.  The people in the medical world know that it is very difficult to plan appointments ahead of time, we are human and share the same difficulties.  However, providers are still paid for time they were scheduled to be with a patient, whether the patient is at that appointment or not.  A new patient appointment at Midcoast Family Dentistry reserves time (up to an hour and a half) with a Dental Hygienist as well as time with a Dental Assistant and Dr. Randy.  One cancellation equals over two hours of sudden free time.

Second, and another great reason to keep your appointments, take a regular hygiene appointment for example.  If you are Susie Patience and you carry dental insurance, you are entitled to use $2000 a year in benefits including two regular hygiene visits per year.  If you come in February as planned, but then cancel your next appointment scheduled six months later, you are reducing the chance that you will be able to take advantage of the full $2000 if you need to have any kind of work done.  Trust me, we see it every year with a good amount of patients.  The sudden realization in the patient’s eyes saying, “Oh no, I still have money available that I could have used but I came in too late?!?”  You and your employer pay good money for these benefits…don’t miss out!  We often hear, “Well my employer pays my dental premium so it doesn’t cost me anything”.  Sure it does!  Any money out of your employer’s pocket is less money available for salaries, operating costs, etc.

Here is an example of how insurance plans vary drastically based on the employer.  Susie Patience works for a bank that has elected insurance through Dental Insurance of America.  Patrick Nicely works for a landscaping company that also selected insurance through Dental Insurance of America.  Susie has a higher maximum available ($2000) to use each year, a lower deductible ($25) and the coverage for a filling is at 80%.  Patrick has a lower maximum ($750), a higher deductible ($75) and the coverage for a filling is at 50%.  It is important for you to know what you have available to you and how much you are entitled to use every year!

Our friendly Treatment Coordinators are more than happy to help you understand your specific and very individualized plan.  It is impossible to know the intricacies of each employer’s plan, but we are very skilled at finding the information you need and we do our best to predict the out of pocket expenses for each patient for each visit.  For best results, we recommend requesting a predetermination (also known as preauthorization) to be sent on your behalf for follow up care.

We look forward to seeing you at your next scheduled appointment!  Your commitment to keeping your appointments with all of your service providers (dentists, doctors, hair stylists and auto care alike) is greatly appreciated!

Randy Thivierge