If cared for properly, your teeth CAN LAST A LIFETIME!
HEALTHY HABITS
Good healthy habits are needed to maintain your wonderful smile PLUS a great dental plan.
But without a plan, costs can stand in the way of getting the dental care needed to help maintain
the health of your teeth and gums. And for seniors, dental is NOT covered under Original
Medicare (Parts A & B). Unless you have other dental options, you would be responsible to pay
out-of-pocket for your dental health care services.
DENTAL PLANS
Many consumers are unfamiliar with dental insurance and plans. As mentioned, Original Medicare
does NOT cover dental. For many years, paying out of pocket for dental care wasn't an issue.
Many people visit their dentist once a year or so and the cost for maintenance was minimal.
Things are different now. People invest more in the health of their gums and teeth. The
unexpected may happen. A root canal can cost as much as a summer vacation trip. The good news
is dental coverage can be affordable. There's a vast array of dental plans available to choose from
for you and your family.
What are the types of Dental Insurance?
1. PPO
2. HMO
3. INDEMNITY
4. DISCOUNT PLANS
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PPO - Offers ‘in-network’ and ‘out of network’ choices. A percentage of the procedure is paid instead of a
set price.
HMO - Offers ‘in-network’ only and a set price for procedures. If you use a dentist not ‘in-network’ with your
plan, you will be responsible for 100% of costs.
INDEMNITY - This plan pays a percentage of what’s considered ‘reasonable and customary’ (R&C) in your
area. This plan calculates a percentage of the R&C and pays that amount.
Example: Crown services. We will use 80% as the R&C rate.
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$2000 cost the ‘out of network’ dentist charges for a crown
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$1800 cost considered ‘reasonable and customary’ for the same type of crown in that neighborhood area
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R&C percentage rate is 80%
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$1800 x 80% = $1440.
The insurance company will pay $1440 towards the $2000 crown. The difference of $560 will be your payment
portion. Some plans only pay 50% R&C which is more costly.
THINGS TO CONSIDER WHEN REVIEWING DENTAL PLANS
1. Is there a deductible? If yes, is it yearly or lifetime?
2. What happens if I need major work now?
3. Monthly premium? Copay?
4. Married to your dentist? Is he/she in network?
5. What dentists are in my network?
6. Additional costs incurred if I go ‘out of network’?
7. What are the ‘wait’ periods and how do they apply?
8. Maximum amount paid per calendar year?
9. Exclusions?
10. HMO dental plans?
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This is where Care2Partner Insurance Services can help. We’re contracted with multiple dental
insurance companies so together, we can look at plans that suits you and your family's needs!
Please click on the icons below to view plans and costs or contact us at 310-463-2403 for a free
‘no obligation’ quote.
CONFUSED YET?
The good news is you do not have to decipher this alone.
