Tips to understanding your dental coverage

Confused by your dental coverage?

Regular visits to Dr. Romano can improve your dental health and if you have coverage, you’re more likely to visit Romano Dental. Those visits can help prevent and monitor dental health issues that could lead to more serious conditions and require more expensive treatment, such as cavities, tooth removal, root canals and even oral cancer.

The good news is that Americans have more choices for dental coverage than ever. Though many people with dental benefits get them through their employers, individual plans are also available through the new Health Insurance Marketplaces established by the Affordable Care Act.

It’s important to know all your options when choosing the right dental plan for you and your family. Use this buying guide to get started—and get covered.

Do I really need a dental plan?
For some people, buying dental benefits may cost more than paying a dentist’s office directly. When considering a plan—especially if it’s not provided through your employer—ask yourself the following questions to estimate how much you might spend out-of-pocket:

• What is your plan premium?
• What is your plan’s deductible?
• What is your co-payment?
• What percentage of treatment costs (coinsurance) will I pay?

 When you consider the total cost of your dental treatment, you must remember to include the cost of the dental plan itself. 

Another important factor to consider is what kind of care you regularly receive from your dentist. Are your regular checkups enough, or do you routinely need procedures (like cavity fillings) performed? Talk to your dentist about your dental history and possible care needs before making your decision. Because your health is always changing, revisit these conversations with your dentist before your policy is renewed each year, or when it’s time for you to choose your benefits at work when you’re hired or during open enrollment.
 Notice that we have used the term dental benefit plan and not dental insurance. Insurance plans are designed to make you whole in the event of a loss. Insurance, by definition, entails a risk of loss to the insurance company. Typical dental benefit plans are not designed to cover all dental procedures, and dental benefits coverage is not based on what you need or what the dentist recommends.

Types of dental plans: Which one is right for you?
PPO and DHMO: alphabet soup or dental plan? Sorting through different dental plans can sometimes feel overwhelming. Get a breakdown of your options, and find out which one is best for you.

How to get dental coverage when you don’t have an employer sponsored plan 
Not all employers offer dental benefits. If you’re struggling to find affordable dental coverage, here are some places to start.

Ask Dr. Romano
Some dental offices are starting to establish dental membership savings plans. Typically, these plans charge you a fixed dollar amount on an annual basis and cover certain procedures at no additional charge (for example, cleanings and exams). After that, other procedures are discounted. Ask Dr. Romano if he offers such a plan.

From the State
Connecticut State Dental Association
835 W Queen Street
Southington, CT 06489-1032
cdingeldey@csda.com

The Affordable Care Act
In 2014, the Affordable Care Act extended health insurance to millions of Americans. About 6.7 million Americans gained health insurance and 1.1 million gained stand-alone dental benefits through the health insurance marketplaces that year. In an American Dental Association study of 40 states, 35.7 percent of medical plans now have pediatric or family dental benefits, up from 26.8 percent in 2014. Learn more at Healthcare.gov.

Oral Health America
Are you over 60 or the caregiver of an older adult in need of dental care? Visit http://www.toothwisdom.org/care/state/connecticut for a list of the resources available in CT

Children’s Health Insurance Program
The Children’s Health Insurance Program (CHIP) provides free or low-cost health coverage for more than 7 million children up to age 19. CHIP covers U.S. citizens and eligible immigrants.

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Contact Romano Dental for questions regarding dental coverage