Okemos, Lansing, and East Lansing, MI
Dental insurance helps patients pay for their oral care, from essential checkups and cleanings to more advanced treatments like crowns and orthodontics. However, it can be challenging to understand how your insurance policy works and what some terms mean. The family dentist in Okemos, Dr. Christine Tenaglia of Tenaglia Smiles, decodes the mysteries of dental insurance so you understand how to best use your benefits before they expire.
What is dental insurance?
Dental insurance helps you pay for oral health care needs when visiting our East Lansing dentist office. Like standard health insurance, dental insurance plans cover most preventative care treatments such as regular checkups and cleanings. Additional coverage for advanced dental conditions such as fillings, root canals, dental crowns, extractions, or orthodontics may be part of your benefits. Some insurance plans require you to pay a deductible before your benefits begin, or you could have a co-pay when you visit the dentist.
Your dental insurance policy outlines who you may visit for oral care, how much the insurance company should cover per procedure, and your out-of-pocket charges for services rendered. With so many factors determining how much you may owe, the front desk staff at the Lansing family dentist near you will be happy to explain your dental benefits so you can financially prepare for your next visit.
What types of dental insurance are available?
Most dental insurance companies provide a telephone number or website to help you find a dentist. However, if you established a dental relationship, ask the front office staff if your insurance is accepted.
- Preferred Provider Organization (PPO) – PPO dental plans provide a list of dentists known as a provider network that will accept the insurance. Visiting a dentist on the list can save money for most dental procedures. If you choose an unlisted dentist, you will pay more expenses out of your pocket.
- (Dental) Health Maintenance Organization (DHMO, DMO, HMO) – HMO dental plans also provide a list of dentists that will accept your insurance for a set fee. However, to use your benefits, you must visit a dentist on the provided list.
Dental Discount Plan – Dental discount plans only offer discounts to dentists on the insurance plan’s list. The discount plan does not pay the dentist for procedures; it merely provides discounted prices for specific procedures. Therefore, you will pay a pre-negotiated amount for treatments.
How does dental insurance work?
Once you identify your plan type and select your dentist, you may want to know your financial responsibility for your next visit to the friendly Okemos dentist, Dr. Tenaglia. Before your appointment, our professional staff will verify your dental insurance coverage and obtain an estimate of what you may owe. Then, we send a request or claim for payment to your insurance company. Finally, your insurance company reviews and processes the claim, transfer payment to your dentist, and mails you an Explanation of Benefits (FOB) to explain your claim’s settlement.
Financial Obligation Terminology
Part of understanding dental insurance is knowing the terminology. Below are some standard insurance terms and a brief description to help you better understand your policy.
- Deductible – The amount of out-of-pocket expense before your insurance pays for treatments.
- Coinsurance – After meeting your required deductible, you may need to pay a percentage of a covered procedure.
- Co-pay – A set out-of-pocket cost for services.
- Annual Maximum – The limit your dental plan pays for treatment during your benefit year. Expenses above the maximum become the patient’s financial responsibility.
- Preauthorization – Certain procedures require the insurance company to pre-approve the procedure.
- Exclusions – Services or products your policy does not cover.
- Waiting Period – Your policy may not cover specific procedures until a specified amount of time passes.
- Limits – Some policies limit specific procedures. For example, checkups and cleanings are generally covered for two visits annually spaced six months apart per benefit year. However, the frequency of tooth treatments or x-rays may be limited.
- Pre-existing Conditions – Oral conditions that exist before choosing your dental insurance plan may make you financially responsible for expenses regarding the condition.
Family Dentist in Okemos, Lansing, and East Lansing, MI
Understanding your dental insurance helps you make the best decisions for your oral health. When you have questions or need help with your policy, the well-trained staff at Tenaglia Smiles, your East Lansing dentist, will be happy to assist you. If you are ready to schedule your next appointment, feel free to call Dr. Christine Tenaglia of Tenaglia Smiles at (517) 347-6733 or schedule an appointment online.