Review your dental insurance today because it’s that time of year again! Yes, as the year comes to a close, it’s open enrollment (Nov. 1-Jan. 15) and that means time to review your dental insurance plan. Whether you’re considering renewing your current plan, upgrading, or switching to a new one, it’s important to ensure your coverage meets your needs.
Take a moment to look at your current plan. We recommend doing this between Nov. 9 and Jan. 9 to be on the safe side. Does your plan still meet your needs? Are there better options available?
Before making any changes, check with your insurance carrier or your orthodontist such as Sky Ortho in Oklahoma. You want to be sure any new plan still covers your current treatment. Your insurance team or local orthodontist team can help you understand your coverage. And, of course, if you have any treatment questions, call your orthodontist.
Why Review Your Dental Insurance?
Reviewing your dental insurance annually helps you stay informed about your benefits. This is especially important if you’re undergoing orthodontic treatment. Changing your insurance won’t disrupt your treatment but it could change your treatment plan so be sure to discuss your insurance changes with your orthodontist’s office.
Benefits of Dental Insurance
Dental insurance can save you money on treatments like braces. Without insurance, orthodontic treatments can be expensive. By having a good dental plan, you can reduce out-of-pocket costs significantly.
Key Considerations for Renewal
When renewing your dental insurance, consider your current and future dental needs. Look at the coverage limits, deductibles, and out-of-pocket maximums. Make sure your plan covers the treatments you anticipate needing.
In addition, there are a few other things to consider. Ensure that the new insurance:
Covers orthodontics for the patient(s) currently undergoing treatment.
Covers treatment(s) in progress.
Has no waiting period(s).
Has no age limit(s) (if close to 19y).
Has no out-of-network orthodontist rule. If it does, be sure your orthodontist (such as Sky Ortho) is included in the network.
Checking with Your Orthodontist
Before switching plans, consult with your orthodontist. They can provide insights into which insurance plans work best with your treatment. This ensures you don’t face unexpected costs or treatment delays.
Treatment in Progress
If you or your child are currently undergoing orthodontic treatment, checking if your new policy includes a “treatment in progress” feature is essential. This ensures that your ongoing treatment will continue to be covered under the new plan. Changing policies without this feature can lead to unexpected costs and disruptions in your treatment.
Understanding Your Options
Do you know the difference between an HMO and a PPO? Dental insurance plans come in different forms. Each has its pros and cons.
HMOs (Health Maintenance Organizations) often have lower premiums. But you may have a limited selection of dentists. Sky Ortho doesn’t accept HMOs. However, if you have an HMO, you may be able to ask your insurance company to reimburse you for paying an out-of-network provider. This places initial responsibility for payment on the patient.
PPOs (Preferred Provider Organizations) offer more choices. But they might have higher monthly costs. Consider your budget and needs. Then, you can choose the plan that fits you best.
Maximizing Your Benefits
Dental insurance can be confusing. Many plans have waiting periods for certain procedures, like braces. Some have yearly maximums on how much they’ll pay, which is not to be confused with the “orthodontic lifetime maximum.” We’ll go over that next.
Once your yearly maximum is reached, you will be responsible for the full cost of any further orthodontic treatment for the current year.
Knowing these details can save you money. For example, if you know your plan has a waiting period for braces, you can plan your treatment accordingly. Don’t hesitate to call your insurance provider. Ask them specific questions about your coverage. You can learn more about orthodontic lifetime maximums on our blog here.
Orthodontic Lifetime Maximum
Be aware of your plan’s orthodontic lifetime maximum. This is the total amount your insurance will pay for orthodontic treatments over your lifetime.
An “orthodontic lifetime maximum” refers to the total amount of money your dental insurance will pay toward any orthodontic treatment throughout your life. This means it applies to all orthodontic procedures you need, not just one specific procedure. Once this limit is reached, you will be responsible for the full cost of any further orthodontic treatment.
Understanding this limit helps you plan your finances better and avoid surprises. This family is preparing to have both children in braces and Dad, too, so no surprises is a great goal.
Don’t Have Dental Insurance?
If you don’t have dental insurance, open enrollment is the time to consider it. Officially, open enrollment runs from Nov 1st until Jan 15th. However, some ins providers may start later or end sooner. In our experience, completing your enrollment by Jan. 9th is best.
Dental insurance can save you a lot of money. This is especially true for orthodontic treatment. Offset dental costs by getting prepared early.
Braces can be expensive. A good insurance plan can significantly reduce your out-of-pocket costs. Many employers offer dental insurance. You can also purchase plans directly from insurance companies.
Exploring New or Improved Dental Insurance Plans
Listen up! Do like this college student and do some cost comparisons. If you don’t have dental insurance, now is a great time to explore your options. Websites like Consumers Advocate and Forbes Advisor offer comprehensive comparisons of different dental insurance plans. These resources can help you find a plan that fits your budget and needs.
Making the Decision
Deciding whether to renew, upgrade, or switch your dental insurance plan can be daunting. However, by reviewing your current plan and exploring new options, you can make an informed decision that benefits your dental health and finances.
If you like the insurance company you currently have but just want to improve on your plan, give them a call. You can always do a plan upgrade or “updagrade” as our younger patients like to say.
Open Enrollment and You
Open enrollment periods vary but to be safe, mark your calendars for Nov. 9th through Jan. 9th. Your employer or insurance provider can advise when you can make changes. Don’t miss this opportunity! It only comes once a year, and it can save you a lot of money.
Review your plan. Compare it to others. You might find a better deal. A little time and effort can make a big difference in dental costs. You can find helpful resources for comparing dental insurance plans on Consumers Advocate and Forbes Advisor.
Changes in Dental Insurance Policy?
It’s important to keep in mind that insurance policies can change. Sometimes these changes happen mid-treatment.
If your insurance changes, let Sky Ortho or your orthodontist know. Your orthodontic team can help you navigate these changes and ensure your treatment stays on track. Read more about dealing with insurance policy changes on our blog here.
