Oregon Dental Insurance
Daily dental care and routine exams, check-ups, and cleanings help you remain healthy. It’s cost-effective and less painful to pay for a dental plan to prevent major dental problems later on. Not having dental insurance and self-dental care may eventually cost you more as dental expenses add up quickly.
Most dentists allow those without dental insurance to apply for Care Credit. It helps pay for out of pocket expenses. Care credit offers healthcare financing to pay for deductibles and out of pocket healthcare and dental costs.
Dental insurance is designed to pay a portion of the costs associated with dental care. It helps cover preventative services and major dental work such as fillings, root canals, dental x-rays, braces and teeth extractions.
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TYPES OF DENTAL PLANS:
Discount Plans – Members receive some discounts on dental workIndemnity or fee-for-service plans-These allow you to pick a dental provider and your plan pays a percentage of the provider’s fee.
Preferred Provider Organization plans (PPO) – These allow you to pay lower copays to see certain in-network or “preferred” providers.
Health Maintenance Organization plans (HMO) – You’re required to see dental providers in the insurance network. Timing is very important. In general, adults need to see the dentist every 6 months. Your dental health policy may pay for a preventive visit every 6 months or twice per calendar year, or twice over a 12-month period. There are also time limits on certain dental services such as fillings on the same tooth, bridges, crowns, x-rays and fluoride treatments. For example, your dental plan may pay for a full series of x-rays only once every 2 years.
HOW TO MAXIMIZE YOUR DENTAL INSURANCE:
It’s important to carefully review your dental policy to determine if a certain dental procedure is covered.
You can always call your insurer to verify coverage.
For major dental procedures, it’s wise to ask your dentist for a pre-dental service estimate. This is to determine how much you’re responsible to pay.
For dental emergencies, it is best to understand any provisions your dental plan has to offer for urgent care.
Timing is very important!
In general, adults need to see the dentist every 6 months. Your dental health policy may pay for a preventive visit every 6 months or twice per calendar year, or twice over a 12-month period. There are also time limits on certain dental services such as fillings on the same tooth, bridges, crowns, x-rays and fluoride treatments. For example, your dental plan may pay for a full series of x-rays only once every 2 years.
HOW DOES DENTAL INSURANCE WORK?
Dental insurance works the same way as medical insurance. Monthly premium vary among dental carriers. You will receive certain dental benefits, normally free or minimum co-pay on annual checkups, cleanings and x-rays. Most dental plans have 6 to 12 month waiting period to cover major services such as crowns, extractions, fillings, dentures, and braces. But some do not have restrictive waiting periods. Coverage could start the very next month upon enrollment. Some plans provide broader coverage than others and some will require higher copays. Some plans may also offer coverage for certain types of oral surgery, dental implants, or orthodontia.
OREGON DENTAL PLAN STRUCTURE:
Most dental insurance plans have the 100-80-50 coverage structure, meaning that for preventive care your plan will cover 100% (dental exams, cleanings, and X-rays) for basic procedures it will cover 80% (fillings, extractions, and periodontal work) and for major procedures it will cover 50% (crowns, root canals, dentures, bridges and implants). In addition, most plans have an “annual maximum” on what it will pay during the entire plan year. If you go beyond this cap, you’re responsible for the rest of the cost. Some Oregon dental plans don’t have a cap or maximum out of pocket. These work best if you’re in need of considerable dental work.