If you don’t work in the insurance industry, it’s not uncommon to be totally overwhelmed or confused by dental insurance. As a parent, it’s important not to allow this confusion to stop your child from receiving the proper dental treatments that they need. To help parents feel less perplexed, Dr. David Moore has put together a guide to understanding dental insurance.
Make sense of insurance terms
Before you start sorting through paperwork and pamphlets, you’ll want to familiarize yourself with common insurance-related terms. Dr. David Moore at Charlotte Pediatric Dentistry has made a list of the most important words to know and their definitions:
- Open Enrollment – Dates when you can enroll in dental insurance or make changes to your existing plan
- Benefits – The amount your insurance company is contracted to pay for services and/or procedures
- Deductible – The total dollar amount the patient is responsible for covering before insurance begins paying benefits
- Co-Pay –The amount the patient is responsible for at the time of services rendered
- Coinsurance - The enrollee’s share of the contract allowance. For example, a benefit that is paid at 80% by the plan creates a 20% coinsurance obligation for the enrollee. Coinsurance applies after the enrollee meets a required deductible.
- Provider - Any licensed dentist who performs dental health services for an enrollee.
You can learn about more dental insurance terms and their meanings here.
Read through your explanation of benefits
Now that you have a better understanding of dental insurance jargon, take a look at your explanation of benefits. This document is a statement from your dental insurance plan describing what costs it will cover for medical care or products you’ve received. It is generated when your provider submits a claim for the services you received and is sent to you to help make clear:
- The cost of the care you received
- Any money you saved by visiting in-network providers
- Any out-of-pocket medical expenses you’ll be responsible for
Does Dr. David Moore take your insurance?
If you’re wondering if your child’s dental insurance is accepted by Dr. David Moore, simply give Charlotte Pediatric Dentistry a call. Many providers, life MetLife, are accepted. If your insurance is accepted, then all you have to do is provide us with your coverage information prior to your scheduled appointment so we can make the verification process quick and easy.