How to Understand Your Dental Insurance Plan
By Krista DeKuyper | December 5, 2022 |
A dental insurance plan is one thing that many people don’t think about until they need it. And even then, many people don’t understand how it works.
That can lead to a lot of confusion and frustration, especially if you need to use your dental insurance for a procedure that isn’t covered by your plan.
In this post, we will explain what dental insurance is and how it works. We will also help you understand the different parts of your plan so that you can get the most out of it.
What is dental insurance and what does it cover
Dental insurance is a type of health insurance that helps you pay for dental care. It usually covers a percentage of your costs, and you will have to pay the rest. Dental insurance can help you pay for preventive care, such as checkups and cleanings, as well as treatments for problems like cavities and gum disease.
Does OHIP cover dental?
No. In most cases, OHIP, and most other provincial health programs, does not cover dental procedures such as cleaning, x-rays, check-ups etc. However, the Canadian government recently introduced the Canada Dental Benefit. This benefit is intended to help lower dental costs for eligible families earning less than $90,000 per year. Otherwise, you will need a private dental insurance plan.
How do I know what procedures are covered by my plan?
When looking for a dental insurance plan, it is important to understand what procedures are covered. Most plans will cover preventive care, such as checkups and cleanings, as well as treatments for problems like cavities and gum disease. However, some procedures may not be covered. It is important to read the fine print of your plan to understand what is and isn’t covered.
For example most plans have two tiers: basic and enhanced. As the terms suggest one covers the basic level of dental procedures while the other covers more. Additionally with an enhanced plan you will pay less but will most likely have a higher premium.
The Manulife Dental Plus basic plan covers you for
- fillings
- cleanings
- scalings
- examinations
- polishings
- and certain extractions
- Plus you get recall visits every 9 months
The Manulife Dental Plus Enhanced Plan covers you for all the above however you get recall visits every 6 months. Plus you also get coverage for
- oral surgery
- Periodontics
- Endodontics
- Orthodontics
- Crowns, bridges
- dentures
So you need to ask yourself what you want in your plan.
Dental Insurance Terminology
Let’s make clear what exactly you get covered in you plan to make sure you’re using your coverage to its full potential.
Diagnostic Services
Diagnostic services help the dentist evluable the condition of a patien’s mouth. There are two common diagnostic services: oral examinations and radiographs (x-rays).
Oral Examinations are an evaluation of the mouth and its surrounding tissues. The most common types of oral examinations are:
- Initial exam (usually 1 every 3 years)
- Recall exam (usually 1 every 6 or 9 months)
- Emergency Exam
Scaling
Scaling is a common dental procedure for patients with gum disease. This is a type of dental cleaning that reaches below the gum line to remove plaque buildup. the process of scaling and root planning the teeth is often referred to as deep cleaning. This treatment goes beyond the general cleaning that you receive with your regular check-up.
Polishing
Tooth polishing is a procedure which not only polishes the teeth but also removes the dental stains, plaque, and microorganisms formed on the other surface of the teeth. The main advantage of tooth polishing over tooth scaling is that it is a painless procedure
Filings
A dental filling is a restoration used to repair a tooth that has been damaged by decay. The filling is made of a variety of materials, including gold, silver, porcelain, and composite resin. It is inserted into the tooth to fill the cavity and restore the tooth’s function and appearance.
How do I use my dental insurance to get the best value for my money?
When you have dental insurance, it’s important to understand how to use it to get the best value for your money. Most dental plans work on a reimbursement model, which means you need to pay for services out of pocket and then submit a claim to the insurance company for reimbursement. However, some plans offer preventive care at no cost to the member. Additionally, many plans have a deductible or coinsurance that must be met before coverage begins. It’s important to review these terms before you choose a plan, as they can impact how much you spend on care. When comparing plans, be sure to look at the total cost of care, including premiums, deductibles and coinsurance. You should also compare the provider networks offered by each plan.
If you’re looking for a comprehensive dental plan that will cover most of your needs, check out Health Quotes instant quoting tool. We offer a variety of plans with different levels of coverage and prices, so you can find one that fits your budget.
