Know Your Dental Insurance Policy
A Insurance Article Contributed by Shobha Cutting
Jargon Used in Dental Insurance Policies:
It is imperative that the policyholder is familiar with all aspects of his/ her dental insurance policy. As such, given below are clarifications in respect of some of the terminology used to convey the benefits and implications contained in your policy.
· UCR: The exact Implications may vary from one insurance provider to another. The initials signify;
U: usual. The fee charged usually by a particular dentist for a given procedure.
C: Customary. A fee determined by the insurance company, based on the range of usual fee charged by dentists in a particular area.
R: Reasonable. A fee that is appropriate, taking into account the circumstances of the service provided.
· Table of Allowances: Specifies the money chargeable for each dental procedure.
· Freedom of choice: Allows the policyholder to choose his dentist and permits full benefits for treatment by that dentist.
· Pre-determination: Once the policyholder and his dentist have picked a particular treatment, the insurance company specifies what part of that procedure will be reimbursed.
· Limitations: The limit in respect of the value of claims, both individually and /or collectively, through the life of the policy.
· Exclusions: The treatment that is not reimbursable by the insurance policy.
· Least Expensive Alternate Treatment: he insurance company is at liberty to substitute with a cheaper but professionally adequate line of treatment.
Know Your Dental Insurance Policy
Do you know the Table of Allowances, Limitations and Exclusions applicable to your dental insurance policy? Is the UCR data and the Table of Allowances used to calculate your claim not old and obsolete? Is a Waiting Period provided for any procedure? Is there a Maximum Limit to any benefit? Does your insurance policy allow Freedom of Choice? Did you know that Dental Care Service Plan is a non-profit organization of participating dentists who agree to charge enrolled patients fees which do not exceed a predetermined level.
What is the prescribed procedure for lodgment of Claims? You must do your homework and find answers to these and other similar questions, to derive the maximum advantage from your dental insurance policy. Share your experiences with regard to the policy with your dentist and also your employer, if he has sponsored your dental insurance policy. Some employers may not provide a dental insurance cover to employees but give direct reimbursement. The patient receives prescribed dental treatment and is reimbursed directly by the employer.
Dental Care Goes beyond the Parameters of Your Dental Insurance
The function of a dental insurance policy is to assist you meet the cost of oral health but dental care is not limited to what is provided by your policy. The best of dental insurance policies may not meet all your needs. Your dental care decisions must be taken by you and your dentist by understanding your specific needs and take into account more than just what is provided for in your policy. Practice the oral hygiene procedure prescribed by your dentist.
