Child Dental Insurance. Tips on how to find the best child dental insurance.

Child Dental Insurance

Finding the right dental insurance for your child

Our office staff will get several questions every day from our patient’s regarding their dental insurance coverage.

Child-dentistry advisor will make an attempt to clarify some of the issues that may be confusing to you as a dental consumer.

First of all, dental insurance was never intended to cover all of your dental bills! Insurance was designed to HELP you pay for dental services needed. The main thing to remember is that your contract is with the INSURANCE COMPANY, not the DENTAL OFFICE.

We will assist you in receiving as much compensation from the insurance company as possible. The dental office did not negotiate the dental plan. Every plan is different! Please do not get upset with the dental staff if you think your insurance company is not covering all of the expenses you think they should. Most dental insurance is part of your wage/benefit package offered by your employer.

As you probably know most insurance companies have a 60 to 90 day eligibility clause. This means that you have to be employed by that company for a certain time period before you are eligible to receive benefits. This time period may be longer or shorter depending on your plan.

Types of Child Dental Insurance

The “BIG PICTURE” for you to understand regarding dental insurance is that there are two general types of dental insurance. There are the “Freedom of choice” plans and the Health Maintenance Organization “List plans.” Most dentists believe, myself included, that you deserve to select the dental office that best serves your family’s needs. This is the “Ideal” situation. If you belong to an HMO dental plan, chances are that you will only have insurance coverage at the dental office on their list. This means that you cannot go to the dental office of your choice if you want your insurance to help pay for your dental bills. You may be tempted to go to the dentist on the “List” because it will cost you less money. I believe you will be happier going to a dentist of your choice. We have had many patients leave our office for the “List” dentist only to return to our office because of a more desirable dental environment, especially for children. Mom/Dad…as with everything else in life, you get what you pay for! If you have a choice, go for the “Freedom of choice” plan!

The other part of dental insurance plans that can become an issue is the fee schedule. Every dental office has a standard fee schedule. Your dentist charges a certain fee for doing certain dental procedures. For example, our office will charge $166.00 for a dental exam, 4 X-rays, a dental cleaning (prophylaxis) and fluoride treatment. Your dental plan may only allow $150.00 for this procedure. Based on this information, you then, will be responsible for the difference between $150.00 and $166.00. Before you schedule any dental appointment that includes certain dental procedures ask the staff how much your dental insurance is supposed to cover. Remember, this is only an ESTIMATE!

Another misunderstanding that comes up frequently is that most insurance companies have a co-pay that you are responsible for paying. It frequently will be an 80/20 co-pay plan. This means that the insurance company will pay 80% of THEIR FEE SCHEDULE. If the dental office has a different fee schedule than the insurance company then you will be responsible for the difference between the two. Remember, you want to prevent any surprises in reference to what your actual “Out of pocket” costs will be. ASK for an ESTIMATE!

Child Dental Insurance

Finding the right dental insurance for your child

Types of Child Dental Insurance

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