Choosing the right medical and dental insurance package can be difficult. There are so many options available. The idea of working your way through all of your options can feel overwhelming. Following these tips can help to take some of the stress out of finding a medical and dental insurance package that works best for you.
What Are The Costs?
Most people look at a medical and dental insurance package and look immediately to the bottom line. They look at how much they will pay out of pocket each month towards a premium. While premium costs are very important, that is not the only cost you should consider. You have to look at the overall costs. As you are examining different packages, you will notice that the higher the deductible (what you have to pay out of pocket before the insurance kicks in) the lower the premium, and vice versa, the lower the deductible, the higher the premium.
When you are evaluating the premium cost you must consider why the cost is what it is. For example, a higher premium could mean a lower deductible and better overall coverage. If you pay a little more for your medical and dental insurance package, you may be getting a better deal. Another thing to consider when you are evaluating costs is how much coverage you will actually use.
If you are 29 and in overall good health, you may not need top-notch coverage that comes with a high premium. On the other hand, if you are 50 and have a few health conditions like high blood pressure, you will need to be monitored more frequently, and spend more time visiting doctors. That top-notch higher premium coverage may be a necessity because it will save you money in the long run.
In other words, do not make your decision based solely on the cost of what you must pay out of pocket for premiums. Let your personal situation guide your decisions. The budget is always important, but don’t sacrifice value. Try to look at the big picture when you are making insurance package decisions.
Do They Cover Dental Care?
One of the most important questions to ask when comparing a medical and dental insurance package is “do they cover dental care?”. The fact is that in many cases, you are either signing up for a medical plan or a dental plan, not both. Years ago, it was common to have both dental and medical coverage under one plan, today it is a bit rarer to find a plan that offers both.
Evaluate your options closely to ensure that both types of coverage are available in the package. Having both coverages under one umbrella will make life easier. Good oral health and physical health go hand in hand. It is important that you are able to get the oral health care that you need and dental insurance will make that possible.
You should also be realistic going into your search for both medical and dental insurance in one package. You will pay a higher premium to have both coverages, but the higher cost is well worth the peace of mind. If you are offered a package that seems to be rather a low cost, beware, it may not provide both coverages. Many people make the mistake that a medical package includes dental coverage and sign on for the low-rate plan, then find out that they do not have dental coverage.
It’s important that you make the right choice from the start. Many packages are only offered during the “open season”. The open season is a specific time of year when you can choose your package. It can be very difficult to change your package until the next open season. Make sure you investigate the plan fully and find out whether the package is a medical and dental insurance package or just medical.
Do They Cover Implant Procedures?
You have found a medical and dental insurance package that covers both medical and dental, but does the dental part cover a dental implant procedure? It is important that you find out. Dental implants have quickly become the standard procedure for replacing missing teeth. Implants are a restorative method that has proven to be the best way to replace a missing tooth or a whole mouth of missing teeth.
Unlike other restoration methods, implants actually take the place of the missing tooth. Historically, to replace missing teeth, dental appliances like full arch dentures or bridges were used. While these appliances are still very much in use today, implants offer something those other restorative methods do not. Other restorative options sit on the gums to take the place of missing teeth. Implants are “implanted” below the gum line into the jaw.
Dental implants are best for restoration because they act and feel like natural teeth. The implant is placed into the jawbone and can help to reduce bone loss. The implant itself takes the place of the root of the missing tooth. The bone grows around the implant as it would if you had a natural tooth in place. It is the preferred procedure, and it is important that you understand if a coverage option is available.
Are Family Options Available?
If you have dependents, it is important that you ask if coverage is available. Ensuring that your family can get to the family physician when they need to and that the insurance coverage will help pay for the costs is essential to your peace of mind and your good health. Dependent coverage is typically an option you can opt-in for with a medical and dental insurance package. However, it is usually at a greater cost.
Of course, you will pay more to add family members to your medical and dental insurance package but that additional cost is well spent. The cost of visiting a doctor or a dentist without health insurance coverage can be astronomical. If one of your children or a spouse gets sick and needs continued treatment if you do not have coverage, that continued treatment can bankrupt you quickly.
People often get aggravated by the skyrocketing costs of medical care and make the mistake of thinking that doctors are “all about the money”. It is not that doctors do not want to help their patients by keeping down costs. A family doctor’s practice is usually a small family owned business, and they have their own overhead to cover. Insurance can help cover the costs of a wide range of medical care. It is important that you consider whether family options are available to ensure that your family has the medical and dental coverage that they need.
Are Cosmetic Procedures Covered?
When you are reviewing the medical and dental package information, look to see if cosmetic treatments are covered. Cosmetic coverage mostly applies to the dental part of the medical and dental insurance package. In almost every case, cosmetic procedures are not covered by the medical part of your insurance except under rare circumstances where there is a proven “medical need” for treatment. For example, if you or a family member have a documented anxiety disorder that causes you to break out in a severe rash, aesthetic treatment to treat the rash may be covered.
The dental realm is a bit different. Some treatments that the best cosmetic dentist practice provides may be classified as “cosmetic”, but may actually be treatments that are necessary to restore your teeth. This can be a catch-22 type situation. For example, the plan may provide coverage for those things that are classified as cosmetic but they may offer coverage at a reduced rate. Let’s use a dental crown as an example. The medical and dental insurance package may provide coverage for a metal crown. You want a porcelain crown. The plan may cover the cost of the metal crown, and you will have to pay the balance that is left for the more expensive porcelain crown.
The best way to determine what cosmetic procedures may be covered is to read the plan information. The quick synopsis of the plan will provide you with a lot of information about the percentages that are covered for specific procedures.
Can You Find a Good PCP In The Network?
You found the perfect medical and dental insurance package. However, can you find in-network doctors nearby? In-network providers are the cheapest way to get health care. Insurance companies have agreements in place with these doctors. The insurance company and a health care provider come to an agreement about how much the provider will charge for certain services. These agreements help to keep your cost share and co-pay costs down.
Using an in-network provider will save you money. Typically, you will find family physicians listed, specialty care providers, dentists, and other health care providers on the in-network medical and dental insurance package. Many insurance companies have websites where you can go to find a local provider that is in-network. You simply put in your zip code and the search engine on the site will populate a list of providers to choose from.
If the medical and dental insurance package you are considering does not have in-network providers nearby, you may want to consider a different package. Getting the healthcare you deserve for you and your family should not mean traveling long distances to be seen. Choosing the right medical and dental insurance package with in-network health care and dental care providers nearby will make getting the care you need more convenient.
Do You Need Specialized Care?
If you need specialty care you want to make sure that the medical and dental insurance package that you are considering covers this type of care. Some packages are “all-inclusive” and will provide coverage for physical therapy and even alternative care like acupuncture. Other packages do not provide coverage for specialty care.
A good example is that coverage for seeing an eye doctor is often not included in medical and dental coverage. It would be best if you secured a separate plan for eye care. Specialty care is typically classified as care outside the basic acceptable care. For example, blood work from your doctor may be covered for diagnostic testing purposes. The same doctor may recommend that you see a nutritionist to help get your diet under control. Your insurance may not cover the cost of seeing a nutritionist even if the doctor writes you a referral.
If you depend on specialty health care services, be sure that you fully evaluate what the medical and dental insurance package covers to determine if it can cover the care that you need. If it does not, you may want to consider a different package.
Choosing a medical and dental insurance package is a highly personal journey. There really is no one size fits all approach. You may have to decide what the most important factors are for you, and then be willing to compromise to find the best package. Rarely will you find one package that offers everything. The best way to choose the best package for your needs is to remain flexible and be willing to give up some coverage to get most of your basic needs met.
It will take a bit of research and some effort to find the perfect package, but it will pay off. Having medical and dental coverage today is essential to both your good health and your finances. The cost of health or dental care should never keep you and your family from getting the care you need. Take your time to find the package that is best for you and your family and, in the end, you will have peace of mind and will be able to protect your finances. Use these tips to make your choice today.