Video 6 Dental Plans and Benefits

Video 6 Dental Plans and Benefits


Dental Plans and Benefits This employer offers two different dental
plans: premium and basic. As you can see the costs are about doubled
for the premium plan. But what makes the premium plan worth more? Let’s take a look at the benefits of both
plans to compare. OK, let’s skip the first line of this table
for now…don’t worry, I’ll come back to it. Annual deductible…$50 for an individual
and $150 for a family. That means that you pay the first $50 of your
service before the insurance kicks in. For a family, you pay a $50 deductible for
the first three people and once you’ve done that, you’ve met your deductible for the
whole family. Both plans are the same in that way. There are four classes of services in these
plans. Class 1: Preventive and diagnostic. These are your cleanings and x-rays. Most plans cover two exams/cleanings and one
set of x-rays per year. This premium pan pays 80% of your bill while
the basic plan pays only half. Now we’re seeing why the premium costs more. Many plans cover your preventive services
at 100% because they want to encourage you in your oral hygiene journey. Class 2: Basic. You have a cavity! Yeck. Don’t you hate hearing that? Well, fillings are included under class 2,
as are extractions, better known as “tooth pulling.” Premium pays 80%, basic pays 50%. If you have a lot of fillings to be done,
it might be better financially to be on the premium plan as it will pay more toward the
cost of services. And take a look at this, here you have to
pay the deductible before this 80% coverage kicks in. Back here at class 1, they don’t make you
pay the deductible for your preventive services. But that deductible is due when you have more
serious issues like fillings. Class 3: Major. Uh oh. You need a crown….or worse, you need a root
canal! No one wants to hear this. But if you chose the premium plan, you will
only be responsible for 20%, after you pay your deductible of course. And with basic, you pay half the cost, after
the deductible is met. Class 4: Orthodontics. This is only for children. That means that the adult who is working and
paying for the plan does not get braces…only the children of said adult, if they are under
age 26. And then only on the premium plan and they
only pay 50% of the cost…..up to $1,250…lifetime. But it’s something right? Annual Maximum Benefit: While maximum benefit
or “benefit limits” are not allowed currently with health insurance, dental is another story. With these plans, there is a limit to what
the insurance company will pay on your behalf. With premium, they will pay $1,250 tops. That includes whatever they paid toward your
cleanings, x-rays, fillings, crowns. The orthodontics is separate with its lifetime
max, though, so that’s good. With the basic plan, the insurance company
will only pay out $1,000 for you in a year. So brush those teeth kids, and don’t be
a stranger to floss.

Author: Kevin Mason

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