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.

Your Dental Benefits for the Year Ahead

by MikeMeehan 2/21/2018 12:26 PM

Now that 2018 is well underway, your yearly expense planning may also be in progress. As you’re organizing your finances and other paperwork in preparation of tax season, it’s also a great time to check on the status of your dental benefits. Here are some things to consider. First, check to see if your dental benefits renew at the calendar year or the contract year, which is usually based on when your plan actually took effect. For example, if your benefits started in April, your benefits would typically renew 12 months later, in April. If your benefits renew at the calendar year, the annual slate will typically be wiped clean on your benefits such as: Deductible: Your deductible is the set dollar amount you must pay out-of-pocket before your dental plan begins to pay for covered services, so you’ll need to meet this amount again for 2018. Preventive services, such as exams and cleanings, are typically covered regardless of whether your deductible has been met. Annual maximum: This is the maximum amount your dental plan will pay toward your dental care within a specific period, often a calendar year. Your annual maximum reset if your plan renewed January 1. If you were holding off on treatment because you reached your 2017 annual maximum, you may want to schedule an appointment now. While you’re assessing your dental benefits, you may also want to review where you stand on lifetime maximums. This is the maximum amount of money your plan will pay toward specific services, such as orthodontics and prosthodontics, over the course of a lifetime. Many services have no lifetime maximum. Always check the specifics of your dental plan to understand any applicable maximums or deductibles.  

Start the Year With This Plan for Your Dental Health

by MikeMeehan 1/4/2018 3:21 PM

For the beginning of the year, we thought we’d start with an outlook for your dental health. You can use this plan for the year ahead to keep your smile, and your family’s smiles, healthy. It’s often the custom on January 1 to start a new perspective or set new goals. Consider making your dental health a part of that. Review your benefit plan (or get a plan) A good place to start is reviewing your benefit plan. Familiarize yourself with coverage, limitations and maximums. Notice the services listed under preventive, basic and major. There are many different designs of dental insurance plans, with many different variations, so it’s best to study your plan and call customer service with any questions, or discuss treatment plans with your dentist. If you don’t have dental insurance yet, you can search for plans and pricing on Delta Dental’s Individual and Family Plans website. Find a dentist Maybe you already have a dentist, but maybe you’d like to look for one closer to home, or maybe you need to find an in-network dentist. Whatever the reason, if you need to find a dentist, try our provider search tool. You can find a dentist through our website or you can use our mobile app. You will get the most out of your benefits with an in-network dentist. Delta Dental network dentists agree to accept predetermined fees, which are usually discounted from typical charges. They also agree to no balance billing, which means Delta Dental network dentists agree not to bill patients for the difference between the contracted fees and their typical charges. Make an appointment If you set the time and date, you’ll be more likely to go, right? Now that you have your 2018 calendar in front of you, plan accordingly, and pick days and times that won’t be at risk of a cancellation or postponement. Commit to twice a day for two minutes You’ve reviewed your insurance plan and you’ve got your dentist appointments set, now for the homework. Commit to brushing your teeth twice a day, every day, and for at least two minutes. Brushing for two to three minutes allows enough time for the fluoride in your toothpaste to do its job. Also, two to three minutes is approximately how long it takes to brush every tooth. Take care of any issues, before they get worse If you’ve been delaying a dentist visit, or if you have some concerns or discomfort but have been pushing them aside, you can make this one of your resolutions – go to the dentist. Don’t wait anymore, it could make any issues worse and more costly. Regular dental visits mean your dentist can address concerns early and treat them before they become serious. That’s why most plans cover 100 percent of the cost of preventive services like exams and cleanings. According to a new poll, 20 percent of Americans plan to make improving their oral health a resolution and 15 percent will make going to the dentist one. We hope you’re part of that percentage, or we hope you will add to that number by following this dental health plan for 2018. 

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