Making Sense of Your Dental Insurance 

By |2022-02-11T11:09:46+00:00February 11th, 2022|Dental Insurance, South Charlotte Dentistry|0 Comments

What You Need to Know About Dental Insurance

Though dentistry is a medical practice, and is a very important part of an individual’s bodily health, navigating your dental insurance isn’t the easiest thing. There are a number of plans, all able to do different things, and the fine print can get pretty detailed. For instance, should you have a DMO or PPO plan? (What do these letters even stand for?). Dental insurance plans are not typically included in regular healthcare, which can leave patients in a pricy predicament that produces negative results. But at South Charlotte Dentistry, we won’t leave you confused as to what is and is not covered. We are committed to taking care of all our patients, and this begins with understanding that dental health is bodily health. 

There are countless tales of woe depicting situations where individuals with mild-to-severe dental issues are not able to receive the care they need because their healthcare provider simply does not cover dental and/or the individual has a poor plan. Because of this, many people end up having to live with the pain caused by cavities, chipped or dead teeth, or even more complicated issues requiring dental surgery.

How can you avoid this from happening to you? Know what is covered, and know what plan is best for you.

Answers to Common Questions

One key question to ask when shopping and comparing dental insurance plans is this:

  • Are there any waiting periods? (Meaning, must one have the insurance for a specific amount of time before certain services are covered?)

What you will find is that most dental insurance plans do not require such a waiting period—at least not for preventive care. X-rays, cleanings, exams, and basic treatments, should all be covered without any sort of waiting period.  

Another good question to ask is: 

  • What is the annual maximum? 

Common dental plans have what is called an “annual maximum,” which is the total amount of money the dental benefits provider will pay for your dental care within a year’s time. This information is not always shared up-front, but clearly, you want to get the most bang for your buck. If you know you will be visiting the dentist for more than basic cleanings, etc. you might want to be sure that the maximum is higher. $1,500 is a typical amount to receive a year. 

Here are a few more pieces of advice for when shopping for dental plans:

  • Though there has been a rise in popularity with DMO (dental maintenance organization) plans—mostly in Medicare plans—it’s important to know that these only cover the patient with a specific provider. When selecting a plan, consider a PPO (preferred provider organization), so you can have access to a much larger network of licensed dentists. 
  • The truth is, there is no best plan. Even plans through the same insurance carrier can vary. For example, no two Cigna plans are the same—one could have very good coverage and the other not at all. 
  • At South Charlotte Dentistry, we offer Kleer, which is a discount plan that makes routine care more affordable while offering a discount for restorative care. This plan is only available to our non-insured patients. We also work with Delta Dental Premier, Metlife, and Aetna Select!


A Strange History

Nowadays, dentists are known to be highly trained professionals who have endured numerous years learning their craft. But they have not always been seen and respected as such. A recent article in the Atlantic provides a brief history of dentistry. The article states that up until the 1800s, all dental problems were taken care of by local barbers. Sounds a little strange, right? Imagine popping in for a quick shave only to have your barber explain that he needs to pull a few teeth. The local barber could become a primitive dentist in a pinch, oftentimes even conducting minor surgeries as well, and it was this way for years because surgery and medicine were seen as two completely different practices. 

A barber could also be a dentist and a surgeon since these practices were messy and barbaric. Bad teeth were yanked from the mouth. Open wounds were sewn back up without numbing agents. On the other hand, deciding what would help a patient cope with pain and injury took time and education. So it makes sense for the separation between dentistry and medicine—at least it makes sense for back then.

Once anesthesia and numbing agents came about, this all changed. Patients could now be put under or numbed, and the practice of surgery and dentistry became more sophisticated. People began to study oral health more seriously, leading to a true profession in the field of dentistry. But even though the idea of dentistry was changing to something proper and professional, the stigma of its previous uncivilized nature had not dropped. Students wishing to pursue studies in dentistry had difficulty gaining acceptance into medical schools, and they were often left to teach themselves.  


The Stigma Continues

Up into the mid-1960s, dentistry was still viewed as something not quite connected to our bodily health. It just didn’t carry the same level of importance to society as other medical practices. And when Medicaid was finally established, dental was not included. But that was over fifty years ago and we know so much more now. It’s clear that oral health is indeed directly connected to our overall health, but for some reason, today’s healthcare providers typically only offer dental for children and pregnant women. This is a scary thought, seeing how anything beyond a teeth cleaning can end up costing a lot of money. And for those who cannot afford such procedures, are left to live with the pain, and, sadly, this pain usually evolves into more serious issues that cost even more money. 

According to The Atlantic, “Just 12 states include the full suite of dental services, including common procedures like crowns and root canals, for Medicaid patients. Three offer nothing at all. The rest provide something in between—usually a list of preventative procedures, like cleanings and x-rays, and sometimes extractions and fillings” (Khazan). 


It Doesn’t Add Up

Think of the results of poor oral health. Bad breath and missing or discolored teeth can, at the very minimum, reduce confidence. They can even keep you from getting that job you want or impact relationships with friends and loved ones. But on a larger scale, poor oral health can effect your very being. Dental problems can cause chronic headaches, diabetes, and heart problems. Nerves that are connected to your mouth can reverberate pain to other parts of your body, resulting in pain all over, not just in the mouth. 


It Gets Worse

There are many dental needs not covered by regular insurance providers. Usually, the dental procedures included are labeled as “Additional Benefits,” because they are considered extra services rather than those normally in need by everyone. 

It’s important to know that healthcare providers are not required to provide the dental services listed and that they have the right to discontinue the coverage of any or all of them as they choose. This means you can go to a dentist one day to have a cavity taken care of, and then come back the very next day for the same procedure only to find out it’s not covered any longer—though, realistically, your provider will most likely let you know when a change has been made. There have been cases of individuals who were covered for a more complicated procedure, such as a root canal, but were not covered for something simple, like a routine cleaning. This is why you need to read the fine print!

Whereas it is strongly recommended to visit the dentist for a cleaning and checkup every six months, most people only see their local dentist once a year at best. Some don’t go at all, because they are confused as to what is and is not covered for them.  


Let Us Take Care of You

At South Charlotte Dentistry we are clear and upfront about everything. We will not only let you know which insurance companies we accept, but we will also help you understand what procedures are covered. Dental care is a health issue, and we take it very seriously. It’s time to get what you are paying for. Begin to take advantage of your provider’s dental coverage, as big or little as it may be, today. 

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