Putting Your
Dental Insurance Plan
Through the Benefits Drill
(ARA) - Newlyweds often find themselves with multiples of many items: toasters, fondue pots, coffeemakers, etc. They may also have duplicate insurance plans once they become husband and wife. If both individuals work, chances are they each have coverage from their employer. Couples should take a close look at both insurance plans and choose the option that provides the best coverage.
The American Dental Association offers the following checklist to help consumers evaluate their dental insurance plan
First, let’s assume the more options your plan covers, the better chance you will have of getting the oral care you might need.
So pull out your dental plan benefits booklet. We’ll use it to help determine the health of your dental plan by rating its important features through this quick and easy drill.
1. Does Your Plan Let You Choose Your Own Dentist?
Begin with a plan rating of "10" ____
Deduct two points if you must choose a dentist from a list of approved dentists ____
Deduct an additional point if your current dentist is not on the list ____
Deduct an additional point if a referral is required to see a specialist ____
Deduct another point if specialist must be approved by plan ____
* My choice of dentist score____
2. What services are covered under my plan?
Begin with a plan rating of "10" ____
Deduct one point if dental implants are not covered ____
Deduct one point if orthodontic procedures are not covered____
Deduct one point if temporomandibular joint problems (TMD) are not covered ____
Deduct one point if posterior root canals are not covered____
Deduct one point if removal of impacted teeth is not covered ____
* My covered services score____
3. How much does my plan pay?
Begin with a plan rating of "10" ____
Subtract two points if it pays a portion of the fee, depending on service provided ____
Subtract two points if the actual plan reimbursement is often less than promised____
* My dental fees score____
4. Are there limits on my benefits?
Begin with a plan rating of "10"____
Add a point if your plan’s annual maximum benefits increased in the last five years____
Subtract one point if your plan has lifetime benefit limits____
Deduct one point if annual maximum benefits have not changed in the past five years____
Deduct two points if annual maximum benefits were reduced in the past five years ____
Deduct one point for each $500 in annual benefit limits below $2,500____
* My benefits score____
** Total Score____
Now let’s total the score:
If your overall score is 33 or higher, thank your employer for providing you with a dental plan that will help you maintain good oral health.
If your dental plan scores between 27 and 32, a little "touching up" of benefits may result in a better plan.
If your dental plan scores below 27, it has a few cavities. You might want to ask your employer about filling those holes.
For more detailed information about understanding your dental plan, please visit www.ada.org/public/faq/insurance.html
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