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Understanding Your Dental Plan

Understanding Your Dental Plan

When it is time for open enrollment and your employer is offering you a choice of dental plans it’s important to know the basics about your benefit plan. (Open enrollment usually takes place in November or early December for most companies.) Your benefits depend on the agreement your employer sets up with its insurance company. The more your employer pays, the less you’ll pay out of your own pocket.

When you’re looking at the details of your plan, check to be sure it includes basic coverage for preventive care and common dental treatments. Also look closely at the limitations of the plan to make sure they’re reasonable and realistic.

Most insurance plans have a "usual, customary, and reasonable" (UCR) fee schedule to decide how much of your care will be covered. A UCR plan will pay either part of your dentist’s fees, or its "customary" fee limit, whichever is less. Because these limits are set by your employer’s contract with the insurance company, they may not reflect the actual costs of dental care in your area. If a plan’s "customary" fee limits are unrealistically low, you’ll end up paying more. The bottom line is, the insurance company can set limits on the amount paid for any procedure.

If you’re faced with options, your dentist office can help you decide what’s best for you and your family’s oral health needs.


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