Whether you are one of the 60% of Americans that has dental insurance coverage or not, understanding a few of these key terms may help you be informed about some common terms.
Terms you didn’t know you needed to know:
- Waiting Period – Some amount of time set by the insurance company that you must wait after enrollment before you are eligible for coverage benefits.
- Network – Group of dentists that agree to provide treatment for a certain plan.
- Annual Maximum – The total amount that a plan will pay for dental coverage in a calendar year.
Out-of-Pocket Costs – Any Amount YOU as an individual are responsible to pay, including any of the following:
- Deductible – Arguably one of the most important dental insurance terms. This is the amount YOU have to pay out of pocket, for covered services before you ever see a nickel from your dental insurance company.
- Coinsurance- The percentage you pay for the cost of a procedure. If your service is $100 and your coinsurance in 20%, that means you pay $20.
- Costs Greater Than Annual Max – Once you exceed this amount set by your policy it is your responsibility to pay for any additional costs.
- Copay – This is a fixed dollar amount that you pay for a procedure. No matter how much the dentist charges your co-pay amount stays the same. So, fees for different offices may vary, but your co-pay never will.