Have you taken advantage of you dental insurance benefits this year? Well, 2014’s not over yet. Here is a friendly reminder (courtesy of Bluebonnet Dental Care). Call the CDA office nearest you to set up appointments for you and your family.
Insurance Benefits: Use It or Lose It
We’re approaching that time of the year again- “Use It or Lose It!” Each year, many clients lose out on hundreds of dollars through their dental insurance provider, simply because time has slipped away. We know life gets busy and before you know it, another year has come and gone and you have not seen your dentist. Don’t forget to take advantage of your remaining dental insurance benefits before the end of the year!
Understanding Dental Benefit Categories
Many dental plans offer 3 classes or categories of coverage. If orthodontics is covered, that is considered a fourth class and typically has a separate lifetime maximum payable amount. Each class provides specific types of treatment and typically covers those treatments at a certain percentage. Reimbursement levels vary from plan to plan, so be sure to read your benefits information carefully.
Here are the typical levels in benefit plans:
Class I (usually called Diagnostic & Preventive)
- Procedures are diagnostic and preventive and are typically covered at the highest percentage (for example, 90 – 100% of the allowable dental charge).
- Give patients a financial incentive to seek preventive care, because such care can prevent more extensive dental disease.
- Includes procedures such as dental exams, cleanings, and X-rays.
Class II (usually called Basic)
- Includes basic procedures — such as fillings, extractions, and periodontal treatment, such as “deep cleanings” and gum surgery — that are sometimes reimbursed at a slightly lower percentage (for example, 70 – 80%).
Class III (usually called Major)
- For major services, such as crowns and dentures. These services are usually reimbursed at a lower percentage (for example, 50%).
- May have a waiting period before services are covered.
Class IV (Orthodontics)
- These services are often reimbursed at 50% up to the lifetime maximum.
Limitations and Exclusions
- Dental plans are designed to help with a portion of your dental expenses. The typical plan includes limitations and exclusions, meaning the plan doesnot cover every aspect of dental care. These limitations and exclusions may limit the type or number of procedures covered, or the number of visits, or may impose age limits.