Handling Clients’ Frequently Asked Dental Insurance Questions
As a broker, you are responsible for helping clients compare plans, enroll in coverage, and answer their questions before and after the sale to help them make the most of their benefits. When it comes to dental insurance, we’ve outlined concise responses to five frequently asked questions for you to use.
1.) How do I compare dental plans?
Clients who ask this question are usually looking for why certain plans are right for them. They want to know what differences in premium and coverage mean for them. With that in mind, we’ve outlined what to expect from two popular and very common dental plan types.
Preferred Provider Organization dental plans usually cover preventive services in full, when a member goes to an in-network dentist. If they go out-of-network, they should expect to pay a percentage of the network discounted rate. It’s important to note that if a patient does choose a PPO plan, they should be mindful of the annual maximum, deductibles, coinsurance and waiting periods that will need to be met.
Maximum Allowable Charge plans usually take even more advantage of dental networks (dentists who have agreed to specific rates for services). For those who choose this plan and visit an out-of-network dentist, it’s important to note that insurance will only cover the network rate amount. But, with its typically lower premiums and out-of-pocket costs, the MAC plan is often the best choice for those who know their dentist is in-network.
2.) What procedures are covered?
The best way to answer this question is to look to the benefits summary. Many procedures are covered through dental insurance; the key is to know if waiting periods apply before coverage can begin, and the amount of coverage to expect on any one procedure, in or out of network.
3.) How do I know if my dentist is in-network?
The best way to know for sure is to check a carrier’s website. For AlwaysCare Benefits, members have easy access to our provider lookup through AlwaysAssist.com, where they can find out whether one of their dentists is in network, and locate other network providers nearby.
4.) Does my coverage mean anything if I go out-of-network?
This is a very common question. The simplest answer is best: Yes, your dental insurance can help lower the cost of dental work in or out of network. However, you will get the most value out of your coverage if you visit an in-network dentist for service. An additional benefit of using in-network dentists is that those offices will file all claims for you. This is usually, but not always, the case with out-of-network dentists.
5.) Is there a dental mobile app available?
For many members and clients, ease of use and accessibility are key issues. There are many smartphone and tablet apps that can help people maintain their oral health. AlwaysCare members have the added benefit of the AlwaysAssist mobile app. This app allows members to view and share their ID cards with family members and dentists, locate and call network providers, and check their benefits and claims.
Are there other frequently asked plan or carrier questions you would like us to address? Let us know in the comments below.