|
|
 |
Dental Insurance Question
I need both upper and lower arches replaced. I also need extractions. I have MetLife dental insurance & phcs health thru my husband’s work.
I am 59 years old.
Would I qualify for any discount on the total cost of the procedure?
-Mary
Thanks for the note, Mary –
We will have to see you, take x-rays, take photos, etc. in order to answer your questions fairly. The cost will depend on how many teeth need to be taken out (we will look to see if in fact they all need to be taken out and give you options), and also the difficulty of the dentures. If you would like to have IV sedation, that is a separate cost that you can consider.
If indeed you need these teeth extracted, we will probably be making immediate dentures (made ahead of time and placed at the same time the teeth are taken out). We can also teach you about the possibility of dental implants if you are interested in those also.
Please call our office and make a denture consult appointment. You can speak with Mary, Debbie, or Maria. If you will give me your phone now, I can have one of those ladies call you and answer any further questions you might have. They can give you information related to your insurance and likely coverage.
Chuck Campbell, DDS
Dale J. Brant, DDSLabels: dental insuran benefits, dental insurance
Ask the Dentist: Cost of Getting Dentures
I am looking to get dentures and I would like to know what it will cost. I am pretty sure all my other teeth will have to be pulled out. I want to know what the cost is without insurance.Sheila
Thanks for the note, Sheila –
We will have to see you, take x-rays, take photos, etc. in order to answer your questions fairly. The cost will depend on how many teeth need to be taken out (we will look to see if in fact they all need to be taken out and give you options), and also the difficulty of the dentures. If you would like to have IV sedation, that is a separate cost that you can consider.
If indeed you need these teeth extracted, we will probably be making immediate dentures (made ahead of time and placed at the same time the teeth are taken out). We can also teach you about the possibility of dental implants if you are interested in those also.
Please call our office and make a denture consult appointment. You can speak with Mary, Debbie, or Maria. If you will give me your phone now, I can have one of those ladies call you and answer any further questions you might have.
Chuck Campbell, DDS
Dale J. Brant, DDSLabels: cosmetic dentures, dental insurance, denture costs
There are some terms used to describe dental insurance benefits that you need to know. Understanding the legalese that surrounds the insurance industry can go a long way toward helping you choose the right policy.
Preauthorization
This is also known as predetermination of costs. This type of coverage involves having your dentist submit a treatment plan to your provider. Your provider then looks at the proposal and determines what benefits they will allow. This decision is based upon your eligibility, covered services, and the limitations of your dental insurance benefits plan. The intention here is to prioritize and plan your dental treatment and to allocate funding in advance to best match your coverage to cost.
Coordination of Dental Insurance Benefits
If you have dual coverage with a spouse, coordinating benefits maximizes the coverage you get from both dental insurance plans.
Non-duplication of benefits
Some people do not like it when you coordinate benefits. They have a clause in the policy that prohibits overlap if you are covered by two plans.
Annual Dental Insurance Benefits limitations
Insurance companies are for profit organizations and therefore do not want to spend an unlimited amount of money. They place annual limits on the dollar amounts, treatments, and procedures you can receive.
Least expensive alternative treatment (LEAT)
Dental insurance benefits tend to favor the least expensive treatment options. You can always choose a more expensive treatment if you are willing to absorb the difference in cost.
Premium adjustments and Re-evaluations
It is necessary that both you and your employer lobby your insurance company to regularly re-evaluate premium levels. This needs to be done in order to ensure that the UCR or Table of Allowances that the company bases its payouts on are in line with actual fees charged by dentists in your area.
Peer Review for Dispute Resolution
This is a system that exists for resolving the disputes between patients, third parties, and dentists. If a case goes to peer review, your individual records, treatments and results are thoroughly examined before a resolution is recommended. This usually resolves any disputes to the benefit of all parties.
How do third parties categorize the services your dentist provides?
There are basically four service categories your dental insurance benefits plan falls under.
Diagnostic
Diagnostic services refer to exams, x-rays, and other services that are used to evaluate your oral health and detect malfunction or disease.
Preventive
These are services that are intended to prevent decay and disease, such as dental cleanings, fluoride treatments and the application of sealants.
Restorative
When teeth become decayed or damaged, they must be repaired with fillings, crowns, inlays and onlays used to restore strength and functionality.
Discretionary (or elective/cosmetic)
These are treatments that deal primarily with aesthetic concerns and are usually considered optional by the provider.
Labels: dental insurance, dental insurance benefits, dental insurance covers, dental insurance plans
Most people who come to us have some kind of dental benefits plan. Even for those who are self-employed or currently between jobs, dental coverage is something that can be obtained on the open market easily and affordably. However, it is very important before you invest in a plan and begin seeking professional care that you take a good, hard look at what is being offered. Knowing what your dental insurance covers before you sit down in a dental chair will help you avoid a painful (and often very expensive) surprise when you check out at the front office at the end of your visit.
Most dental insurance covers a specified amount of dental care per annum (that means per year). Prior to choosing a plan, you need to be honest with yourself about how much treatment you plan to seek over the next 12 months. You also need to do your best to calculate how much of this treatment will be covered by your new plan and how much you will have to pay for out of pocket.
We recommend that you consider the following criteria to be the base minimum of what dental insurance covers under reasonable circumstances for persons in relatively good dental health.
- Most dental insurance covers the initial oral examination you always receive when you see a new dentist for the first time.
- Dental plans also should cover checkups every six months.
- It is also reasonable to expect your plan to cover a full set of x-rays once every three years.
- Under a good many plans, dental insurance covers bitewing x-rays once a year.
- Teeth need to be cleaned once every six months by a dental professional. Make sure your new dental insurance covers this as well.
- A topical fluoride treatment should also be included in your plan. We recommend this treatment be performed twice every year.
- For children under the age of 18, sealants should be applied to protect teeth against decay and cavity formation.
While we acknowledge that many of these treatments are either diagnostic or preventative by nature, we believe they are absolutely necessary to optimal oral health. Without prevention, cure can be both costly and painful. Dental care is not nearly as expensive as the consequences of dental neglect.
Thanks to increased public awareness of the need for aggressive preventative dental care, we have seen a sharp decline in recent years in the number of cavities and root canals that always result from people ignoring problems and hoping they will simply go away. Even better news than this pertains to our children. Over half of the kids currently enrolled in school have never had a cavity. There has never been a time in history where we see such widespread dental health among the masses.
While there will probably never be a truly perfect dental care plan, finding dental insurance that covers the preventative basics and the occasional intervention treatments that do sometimes have to be done will go a long way to preserving both your health and pocketbook in years to come.
Labels: dental insurance, dental insurance covers, dental preventative care, what dental insurance should cover
Can I Afford Dental Implants?
Ask The Dentist The Cosmetic Dentistry Center in the Houston Medical Center Dental Group offers the full range of cosmetic dentistry procedures and general dentistry practices. Every patient is treated as a genuinely unique individual with his or her own set of unique and specific needs. We like to say that no two smiles are exactly alike, so when you come to our office, you can be confident we provide your smile with a restorative or cosmetic solution that is specifically created just for you._______________I am a 36yr old male. About four years ago I had several molars pulled. They were in bad shape from heavy meth use. I have been drug free for 12yrs. I would like to get dental implants but I am not sure I can afford it. I have insurance, but I’m not sure what or how much it covers. So I guess my question would be how much this procedure cost ??
________________
Thanks for the question --- it sounds like you are a perfect candidate for dental implants. As you suspect, dental insurance will be limited. There are always things that they will cover and other things that they will not cover. After we get a good examination with x-rays and photos, we can give you a pretty good idea of what your insurance will help you with. A predetermination will also give you more information.
That said, the majority of the cost will not be covered by your insurance, so we often advise patients to make their financial plans based on the total cost, and then any money available from insurance is a pleasant surprise and will be helpful. You cannot make your plans on complex dental work based on dental insurance.
Costs vary widely according to what you need. There will always be options that you have for dental treatment, and each option is different in cost. Honestly, the only way we can help you to understand your needs and options and the cost options is for you to come in and have a complete exam that includes photos and x-rays. Otherwise, we would be just guessing. Give us a call and let one of us help you understand your situation.
Chuck Campbell, DDS
Dale Brant, DDS
(713) 795-5905Labels: cosmetic dental implants, dental insurance, finacial options for cosmetic dental implants
|
