Understanding Dental Coverage for Your Child

Understanding dental insurance can be quite a hassle, but we know it is essential to keep your children’s smiles healthy. Not every plan is the same, and learning about your insurance coverage isn’t always a simple task. If you’ve been left scratching your head about your dental insurance plan and how it applies to your family, keep reading.

Read Your Explanation of Benefits

It might seem daunting to sift through the giant stack of paperwork you receive when you sign up for benefits, aka: your explanation of benefits. However, it is inherently necessary if you are going to thoroughly understand your coverage.

You won’t be able to ask the right questions if you don’t know where to start. Reading your explanation of benefits is a good place to begin. Doing so will allow you to form plan-specific questions.

Get Familiar With Insurance Vocabulary

Oftentimes, the most difficult part of understanding dental insurance is the vocabulary. In order to understand your coverage, you need to understand the language. Get to know familiar terms such as:

  • Deductible – Total dollar amount the patient is responsible for covering before insurance begins paying benefits
  • Benefits – The amount your insurance company is contracted to pay for services and/or procedures
  • Co-Pay – Dollar amount the patient is responsible for at the time of services rendered
  • In-Network/Out-of-Network – Services provided in a dental insurance policy either by a contracted or non-contracted dentist. In-network dentists are considered to be contracted and are therefore obligated to provide treatment coverage as outlined by certain guidelines
  • Open Enrollment – Period of time when you can enroll in dental insurance or make changes to your existing plan
  • Preauthorization – Recommended treatment is presented to the insurance company to determine how much will be approved for coverage

Those are just a few of the basics. Familiarize yourself with more common insurance lingo here.

Take Advantage of Resources

Dental insurance is something that is inherently necessary for the health and well-being of your child, so you want to have as much knowledge as possible about what you’re paying for.

Researching dental benefits on a computer

Don’t be afraid to research and ask for help.

If you are unsure, ask! Have a customer service representative for your insurance company walk you through any portions you are unsure of. It is better to ask many questions than to be left with a bill (or multiple bills) that you don’t understand. Don’t forget to utilize blogs, podcasts, and Google to assist you with general questions that aren’t plan-specific.

Ask Your Pediatric Dentist

Still unsure of how the terms and coverage apply to your child’s needs? You’re not alone. Dealing with insurance companies can be time-consuming and headache-inducing. Oftentimes, your pediatric dentist will offer to call your insurance company and acquire a detailed explanation of your benefits. This helps give you and your child’s dentist a more clear understanding of the services your insurance company will cover.

Maximize Your Benefits

Your trusted pediatric dentist will be able to suggest needed treatments and maintenance for your child. Leftover insurance benefits don’t roll over into the new year, so make sure you get the most out of your plan and schedule an appointment for your child to use up the rest of your benefits.

Charlotte Pediatric Dentistry will be able to help you understand procedures covered and requirements given by your insurance company. We want to make you and your little one’s experience as simple as possible, starting with taking the guesswork out of insurance coverage. We also have a simple and clear bill pay system. If you have questions about how your insurance works with our practice, contact us today!

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