Terms Conditions Exclusions & Limitations
This is not a dental insurance plan, this is a dental savings plan for eligible members. It may only be used at McQueen Dental and it cannot be used in the following cases.
- In conjunction with another dental plan
- For dental care covered under workman’s compensation
- For referrals to specialists
- For hospitalization or hospital charges of any kind
- For dental care which is covered under automotive or medical insurance
- For oral health products that may be for sale
- For dental work that, in Dr. McQueen’s sole opinion, is beyond his ability level
No refunds will be issued at any time if the participant decides not to utilize the dental savings plan.
Our Dental Membership Plan provides members with significant savings on dental services
Who Can Benefit From A Dental Discount Plan
People who dont have access to health insurance, or whose health care plans dont include dental coverage, will benefit from a discount dental plan.
You and your family members will save money on virtually every procedure that would require you to pay full price out of pocket otherwise.
Dental discount programs can also provide supplemental coverage for people with Medicare, or people whose medical plans cap their coverage.
Many traditional dental insurance plans wont cover more than $2,000 per year. For expensive procedures, like root canals, this can be used up quickly. Dental discount plans can act as supplemental savings plans when your dental insurance runs out.
Anyone looking for savings on cosmetic dental procedures will also benefit from a discount plan. Insurance coverage typically does not apply to elective or cosmetic procedures. These are often quite expensive, so the savings youll get from a discount program will far outweigh the cost of your membership fee.
How Does Dental Insurance Work
Dental insurance is available as a standalone policy. Depending on your dental plan, you may have deductibles, coinsurance, copayment, and provider network restrictions. Your dental insurance policys benefits, limitations, and exclusions details should clearly specify your out-of-pocket costs and what procedures and services are covered.
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Will Dental Insurance Save Me Money
You may qualify for dental insurance through your employee benefits or you may be looking at an individual plan. Dental insurance plans have a lower maximum coverage limit than most people realize. Often the amount is about equal to the monthly premium costs. The plan may make sense once you have multiple people on the plan, and the maximum amount applies to individuals and not to the entire family. The insurance will help you to negotiate a lower rate with the dental care that you receive above your current coverage.
Dual Dental Coverage: Can I Have Two Dental Insurance Plans
What is dual dental coverage?
If you are covered under two different dental insurance plans, then you have dual dental coverage. Dual dental coverage typically occurs when you have two jobs that each provide dental benefits, or you are covered by your spouses dental plan in addition to your own.
Having dual coverage doesn’t double your benefits, but you might pay less for dental procedures than if you were covered under just one plan because treatment costs may be shared between your two carriers up to 100%.1 All dental plans will have contractual language to determine how coordination of benefits will be handled between the two plans and how it could impact your out-of-pocket costs. Because state laws and regulations play a substantial role in determining how insurance benefit coordination occurs, there may be variations in how they work in your state, so it is best to check with your insurers to find out exactly how COB works for you.
Some COB provisions limit what a plan will cover, while others can involve a detailed process to follow. COB provisions may also depend on individual state laws and regulations, and other variables that vary by state.
In this article, well explain how dual coverage works, along with some related terminology and limitations to be aware of.
How does dual dental coverage and COB work?
Will I receive twice the benefits?
Heres an example of how these limitations could work:
How do I know which is my primary carrier?
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Question: Can You Combine Dental Insurance With Dental Discount Plans
Its up to your dentist whether you can combine dental insurance with their dental discount plan.
Some dentists will let you use their dental discount plan to reduce your out-of-pocket dental care costs once youve reached the annual maximum on your dental insurance plan.
What Is A Discount Dental Plan
Discount dental plans are an affordable, easy-to-use and hassle-free solution for anyone looking for dental care savings. Below is a comparison guide between discount dental plans and dental insurance to help you make an informed decision.
DISCOUNT DENTAL PLAN Characteristics Include:
- · No annual limits plan members enjoy discounts on most dental care services all year long
- · Most plans activate within 3 business days
- · No tiresome paperwork hassles plan members simply present their membership card at a participating dentist office for discounts on most dental services
- · No health restrictions there is no need to wait for comprehensive dental treatment plans
- · Select plans include discounts on dental specialties, including cosmetic dentistry and orthodontics
- · Consumers pay affordable membership fees for access to a network of dentists offering discounts on most dental procedures
- · Available directly to individuals, families, businesses and groups
DENTAL INSURANCE Characteristics Include:
- · Certain dental specialties, such as cosmetic dentistry, are rarely covered
- · Consumers pay expensive monthly premiums for defined coverage
- · Typically inaccessible to individuals and families unless provided by their employer
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What Types Of Insurance Use Open Enrollment
If you get health insurance through your job, through Medicare, or through the Affordable Care Act marketplace, you will have an open enrollment period. For ACA plans, state-based markets may have open enrollment periods that differ from federal-based marketplaces, as well as special enrollment periods. Visit your state health insurance website to find state-based open enrollment and special enrollment period dates.
What Do Dental Savings Plans Cover
Dental savings plans cover preventative and restorative dental work. They also cover specialist care provided by endodontists, orthodontists, and prosthodontists. Many cosmetic dentistry procedures and prescription drugs are covered as well. .
Common dental treatments that discount programs cover include:
- Routine check-ups
- Bone grafts
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There Could Be A Better Option: Discount Dental Plans
A better option could be a discount dental plan. What are discount dental plans? They provide you a network of dentists and dental specialists that offer their services at a discount. The discount can be as much as 60% to 70% off the UCR fee. You pay a very low monthly or annual fee. In return, you pay per a fixed fee schedule which the dentist or specialists agree to. It sounds like insurance, but it is not.
Since a discount dental plan is NOT insurance, it might be a better option than dental insurance. We discuss the benefits next.
Think of it as having a membership card for dental care needs. Some people compare the dental discount plan to that of a Costco or BJ membership for a fee, you receive savings off your dental care needs.
There are some major differences between a discount dental plan and dental insurance, which we outline and elaborate next.
Are Dental Discount Plans Worth It
If you cant afford insurance, or you dont like the idea of insurance, dental discount plans are worth it because you can save a lot of money on routine and restorative dental services. Anything that makes it easier to pay for essential dental work is a smart investment in your health.
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Who Should Consider A Dental Savings Plan
Dental savings plans may be a better fit for some people than others. If you’re wondering whether you should try a dental savings plan, here are some scenarios in which one might make sense:
- Your dental care needs are minimal: If you have good oral hygiene and don’t need care beyond check-ups and cleanings, then you could save money with a discount plan option.
- You have extensive dental work:A dental discount plan could also work for you if you have dental insurance but it doesn’t fully cover all of your care needs. Having both dental insurance and a dental savings plan could help you save money when it comes to paying out-of-pocket expenses for dental care.
- You need dental care while you’re between jobs:If you become unemployed and lose your dental insurance, then a discount plan could help fill the gap until you’re eligible to enroll in your new employer’s insurance plan.
- You’re on Medicare:Medicare covers medical care but not most dental care. If you’re on Medicare and need preventive care, basic, or major dental services, a dental discount plan could help keep your costs to a minimum.
Dental Discount Plans Beat Insurance
With drug costs now covered by Medicare, dental care is the largest out-of-pocket medical expense for many a retiree. Count on spending some significant bucks if you like the idea of using your own teeth. Whereas a cheap set of dentures costs $395, saving a single diseased molar can run $2,000 .
Insurers see an opportunity here. Only 30% of old people are now covered by a dental plan, compared with 54% of working age adults and 80% of children. “Aging boomers are accustomed to having coverage,” points out Evelyn Ireland, executive director of the National Association of Dental Plans.
During the past two years UnitedHealthcare has rolled out individual dental plans in 30 states and Aetna in 4. Cigna plans to jump in next year. AARP, the old people’s lobby, took its dental plan nationwide in 2007.
Should you buy individual dental insurance? Probably not, unless you need insurance as a spur to get yourself to the dentist for regular checkups and cleanings.
Instead, consider a dental discount plan, if you can find a good one in your area. For about $100 a year you get access to a network of dentists who have agreed to work for the sort of reduced fees they accept when they sign up for an insurance plan’s preferred provider network. Cigna says 82% of the dentists in its group dental network also participate in its discount plans and accept the same rate for both. In its Miami plan an exam might be $36 instead of $69 a crown $535 instead of $981.
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First Up: Dental Insurance Plans
The first insurance plan we looked at was Healthplex’s Dentcare Adult, an $11/month offering on the New York health insurance marketplace.
Dentcare Adult’s annual cost is comparable to a dental discount plan and has no waiting period for procedures. A patient under the plan pays $48 per visit regardless of the type or number of procedures suffered and the annual out-of-pocket expense is capped at $480 .
The downside to such a bargain plan is that it offers limited to no coverage for more expensive treatments. While the procedures cleanings, cavities, and an extraction would likely be covered, Kevin’s root canal would not, and he’d have to accept a cheaper stainless steel crown or pay full price for a more natural looking porcelain version.
The troubling part about the plan is that this exclusion is only mentioned once, on page 16 of the 40-page contract, while all the rest of Dentcare Adult’s literature implies the exact opposite by listing root canal therapy as a covered treatment.
For our second test insurance plan we looked at EssentialSmile 111, a $26/month policy from Solstice that’s sold off the marketplace. EssentialSmile 111 also has no waiting period, and unlike Dentcare Adult would help cover Kevin’s expensive molar troubles.
But its premiums are more than twice as high as Dentcare Adult. So it wouldn’t be the best deal for James and Mary. We break down the costs by plan in the table below.
Dental Insurance Vs Dental Discount Plans Explained
It’s difficult to make a universal recommendation because of how greatly costs can differ depending on where you live. Also, state’s insurance exchange will offer different adult dental plans . Still, there are few general findings on dental insurance vs dental discount plans.
If you have healthy teeth and don’t expect any serious trouble, a basic dental insurance policy will likely suffice, because the small savings you might see from a good discount plan probably isn’t worth the extra time it will take you to shop for one. On the other hand, if you know you’re going to be spending some time in the dentist’s chair soon, and especially if you require an expensive dental procedure immediately, the right discount dental plan could save you hundreds of dollars a year.
We also found the cheapest dental discount plans aren’t of much value, meaning you need to compare specific procedure discounts in order to find the plan that best suits your needs.
Be prepared to do some research to uncover a plan’s exclusions and limitations before you buy, or you might be surprised by unexpected expenses later.
Freelancer? Here’s how to shop for dental insurance.
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How To Select Or Change Your Health Insurance
To change your health insurance coverage through the Marketplace during the open enrollment period, fill out a new application on healthcare.gov. Youll need to create an account on the site to do so. At the end of the application process, youll see all available options for the types of coverage and plans youre eligible for. This is also the same course of action youll take if youre selecting a plan from the Health Insurance Marketplace for the first time. You can then review the different options and use the comparison tool to determine which plan is right for you.
Outside of open enrollment, policyholders can only make changes in the Marketplace if they have a circumstance that triggers a special enrollment opportunity. To report this change, sign in to your Marketplace account and select the appropriate year under Your Existing Applications. Then, press Report a Life Event and follow the instructions on the screen.
To cancel coverage from the Health Insurance Marketplace altogether, click My Plans and Programs. Then, click End All Coverage. Youll have the option to choose from available dates when the coverage officially ends. Youll also want to make sure that the end date doesnt leave any gaps between coverage from the Marketplace and coverage from a new policy.
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About The State Of Texas Dental Discount Plan
Careington International Corporation has offered dental discount plans since 1996 and is one of the most recognized discount dental plan providers in the nation with a network of more than 9,800 dental offices in Texas. Plus, enjoy savings at more than 67,000 offices across the nation*.
- All dentists must meet highly selective credentialing standards based on education, background, license standing, and other requirements.
- You may visit any participating dentist on the plan and change providers at any time.
*This plan is available throughout the United States, excluding the state of Vermont and U.S. territories. Participants may also access savings on dental care in the United Kingdom.
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Open Enrollment : How To Buy Renew Or Change Your Health Insurance
Its official. On November 1, the open enrollment period the time each year when you can purchase or make changes to a health insurance policy began. If you already have a policy, your insurer mightve sent you a letter or another notification that you need to take action during this period to maintain your coverage. And if you dont have a policy yet, this is the time of year when you can sign up for one under the Affordable Care Act .
Open enrollment is one of the few annual opportunities you have to make changes to your health insurance policy. For some, open enrollment is a time of significant change. For others, it might just mean confirming a current policy is working well and carrying that same coverage into the following year. Its a busy but important time of year, and theres a lot you might need to take care of. To get started, learn more about what open enrollment is and how you can make the most of this annual opportunity.
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Is A Dental Savings Plan For Me
Dental savings or discount plans are typically good for one year. Like dental insurance, you will need to renew your coverage after a calendar year has passed. Unlike health insurance, discount or savings plans require an annual membership fee.
If you do not use the services in your dental savings plan, you may spend more money than you save. However, if you want help paying for expensive treatments like cosmetic dentistry or orthodontics, including clear plastic aligners, a dental savings plan might be your best option, alongside regular dental insurance.
Depending on where you live, different dental savings plans may cover different providers at different rates, so investigate which plans get the best percentage reduction in your area.