What’s the Difference Between Copay and Coinsurance?

by MikeMeehan 3/21/2018 1:39 PM

Copayment and coinsurance are both ways you help share the costs of dental care with Delta Dental. Most of the time, Delta Dental members have a copay or coinsurance, but not both. Here’s what you need to know: Copayment, also known as a copay, is a set amount you are required to pay your dentist for a service. When you have a copayment, you may not have to worry about a deductible or an annual maximum. A deductible is the set dollar amount you have to pay before your dental plan kicks in for covered services. Deductible amounts vary from plan to plan. An annual maximum is the most a dental plan will pay toward your dental care within a specific period, typically a calendar year. Coinsurance is a fixed percentage of a treatment cost you share with your dental plan. For example, you may be responsible for 20 percent of a given service while Delta Dental covers the other 80 percent. Meaning that if your total bill is $100 for a given service, you’ll pay $20 and Delta Dental will pay $80. However, you must first meet your deductible and you may have an annual maximum for the year. To learn more about your dental plan’s copay or coinsurance, login at deltadental.com or on Delta Dental’s free mobile app. You can also call the customer service number on your Delta Dental ID card.

Ask for a Pretreatment Estimate to Avoid Surprises

by MikeMeehan 10/5/2017 10:44 AM

Some of you might like surprises, but not when it comes to your dental bill. Let’s try to stop that tingly sweat from appearing on your skin when you open a bill. Asking for a pretreatment estimate can help you plan and budget and encourage a discussion with your dentist. You can avoid any unwanted surprises, while keeping a smile on your face, and keeping that smile healthy. A recent study showed that cost is a major barrier to dental care. Cost also causes people to delay receiving dental care. Preventive care is important when it comes to your oral health because it can avoid big problems later. When you’re visiting your dentist, or calling to make an appointment, ask your dentist to submit a pretreatment estimate to Delta Dental. It will help you find out if the procedures are covered, if you will exceed your maximum, and how best to plan for your payment portion. Then cost can stop being a barrier between you and your dental care. How it works A pretreatment estimate is free. It is sometimes called a predetermination or preauthorization. This estimate will give you an approximate cost for your dental treatment. It will also tell you what you’ll need to pay out-of-pocket. When your dental provider puts in a request for a pretreatment estimate, they also submit a treatment plan and x-rays that are relevant. This helps the Delta Dental consultant make the determination. After the consultant’s review of your benefits and the information sent by your dental provider, Delta Dental will send a response to you and your dentist’s office. This estimate will include how much the treatment will cost according to your dental plan and how much you will be expected to pay. This estimate is based on the dental plan you have, your eligibility, your current plan benefits and the amount remaining in your annual maximum. If your case is complex, a pretreatment estimate can take longer, so consider that and plan accordingly. On cases that are not complex, an estimate should be returned quickly. Why pretreatment estimates are helpful Pretreatment estimates can help you set a budget and plan for your dental procedures. The estimate can also encourage a conversation between you and your dental provider to discuss the treatment and the best way to proceed. This conversation can also help you learn more about the procedure, and if there are any alternate treatments and procedures based on your dental plan. For procedures such as crowns, wisdom tooth extractions, bridges, dentures and oral surgery, which are more costly, pretreatment estimates are especially useful. Get your preventive visits in, take care of your smile and take away any surprises when it comes to your oral health and dental bill.

What types of dental plans are available?

by MikeMeehan 9/13/2017 9:23 AM

The type of dental plan that’s right for you depends on your personal preferences: Would you pay slightly more to enjoy the flexibility of visiting any dentist? Or is a low price a priority? Here’s what you need to know: Preferred Provider Organization (PPO) plan allows you to visit any licensed dentist, but Delta Dental has established lower fees with our in-network dentists to help you save money. Use our Find a Dentist tool to see if your dentist is in our network, or to find one who is. You can also use the Delta Dental mobile app to find a network dentist. A Dental Health Maintenance Organization (DHMO), or prepaid plan, lets you pay a fixed dollar amount for treatments, and has no deductibles or annual maximums. Preventive services like exams and cleanings are covered at little to no out-of-pocket costs to you, as long as you visit your selected in network DHMO primary care dentist (exceptions apply in some states). To find a DeltaCare® USA (DHMO) dentist, use our Find a Dentist tool. Dental Savings Programs, also called discount plans or cards, give you access to certain dentists who have agreed to charge discounted fees for select services. You pay the dentist directly with no need to file claims or fill out paperwork OVERVIEW PPO plans: Slightly higher premiums, but you’ll be able to choose any dentist. DHMO plans: Lower premiums, but your dentist options are limited. Discount plans: Discounts available on certain procedures with specific dentists. Ready to purchase a dental plan? Visit individual.deltadentalmo.com to purchase a plan or find additional information.

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