Shopping for Dental Insurance?

Has a change in plans found you shopping for dental insurance? If you are shopping for a dental plan, here are a few things we suggest you consider:

  • Networks. Will the plan allow you to see an in-network or out-of-network provider? Is there any difference in the coverage for visits at an in- or out-of-network provider?
  • Maximum Annual Benefit. How much will the plan pay per year? Is it based on a calendar year (January through December) or benefit year (July through June or ???)
  • Deductibles & Co-Pays. Most plans will require you to pay a deductible for certain categories of treatment before the plan’s benefit applies. Does that deductible apply to preventative and diagnostic services (checkups and cleanings?)
  • Waiting periods or other exclusions. Some plans require you be covered for a period of six to twelve months before basic and/or major restorative treatments are covered. Some plans may waive part or all of the waiting period if you are moving from another plan within a certain period of time. Similarly, some services may not be covered at all – such as implants or bonegrafts. Most plans have frequency limitations on nearly all services.
  • “Cleanings”. If you have a history of periodontal disease and need “periodontal maintenance” (vs “regular / prophy”) cleanings, make sure you understand whether the periodontal maintenance will be covered and, if so, whether it is covered as “preventative” or another category which may require a deductible and/or copay.
  • Where to look. Our office is “in network” with Delta Dental as Premier and PPO providers.
    - Moda/ODS
    ⋅ Several Delta Dental individual plans with different network / deductible / copay options
    ⋅ Waiting periods may be waived
    ⋅ Does not cover implant services
    ⋅ Go to https://www.modahealth.com/plans/individual/dental.shtml
    - AARP
    ⋅ Members may be eligible to enroll in an AARP plan through Delta Dental.
    ⋅ Several plans with different network / deductible / copay options
    ⋅ Implants are covered with certain limitations and exceptions
    ⋅ Go to www.aarpdental.com/coverage
     - Oregon Health Plan
    ⋅ Screening questions to see if you qualify
    ⋅ Apply online or download and print the application
    ⋅ Find community partners who can help you apply
    ⋅ Go to www.oregon.gov/oha/HSD/OHP/Pages/Apply.aspx
  • No Insurance? No problem!
    - We accept Visa, MasterCard, Discover, AmericanExpress, and CareCredit
    - 10% senior discount on all services for patients ages 63+ who do not have insurance.
    - 7% cash discount for non-insured patients when services total $250 or more and are paid in full with cash or check at the time of service.

If you have additional questions, our friendly Front Office staff is happy to help!

Leave a Reply