Different Dental Insurance Terms

Dental Health
By: Spirit Dental
July 17, 2017

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Are you thinking about getting dental insurance for yourself and/or family. If so, you are going to want to familiarize yourself with different essential dental insurance terms to be sure that you know what you are getting into. In this article, we will go over some of the most common and essential insurance terms that you should familiarize yourself with.

Different Dental Insurance Terms:

1.  Agent.

An agent is someone that is licensed to sell insurance products like dental insurance. He/she may be a captive agent that is only authorized to sell a single carriers policies. Whereas, an independent agent is going to be able to sell you many different carriers' products.

Tip: If you are looking for the best coverage and price, you will want to go to an independent insurance agent because you are likely going to get the best deal. A captive agent is only going to be able to sell you on a single carriers policies and this will limit your options.

2. Allowable Charges.

This is the maximum amount of money on which the benefit payment is based for each dental procedure.

Tip: This means that you are only going to be able to receive this much payment for each dental procedure.

3. Annual Maximum Benefits.

This is the maximum amount of money that is to be paid out by the dental plan in a single calendar year.

Tip: If you go over this amount, you are not going to receive the payout from your insurance policy.

4. Basic Care.

Basic care coverage includes different procedures and dental care in your plan including; dental procedures used to restore and repair individual teeth caused by decay, infection, trauma, attrition, erosion, and/or abrasion. Basic services typically include; amalgam restorations, fillings, composite restorations, extractions, and other kinds of dental repair.

Tip: This type of care is typically sufficient for those with good oral health and hygiene.

5. Benefit.

A benefit is the amount that is payable by a third party towards the cost of different dental services that are covered by the plan.

6. Broker.

A broker is someone that is both; licensed and authorized to sell insurance products for various different carriers.

7. Claim.

A claim is the charges for dental products and services that are always submitted by either the provider and/or policy holder to the insurance company in order for them to be reviewed.

8. Coinsurance.

Coinsurance is actually an arrangement between the carrier and the insured person in which the insurance company will pay a certain percentage for a different set of services and the remaining percentage is to be owed by the insured party.

9. Copay.

The copay is an arrangement set forth in which the insured pays a specific amount at the time of dental service. An common example would be the insured paying $20 for a dentist visit. Dental copay actually is different than those applied to medical office visits because a copay on dental services is typically added onto the cost of the insurance that must be paid at the time of the service.

These dental insurance terms should get you going. Be sure to do your research when trying to find the best dental insurance coverage for you and your family.

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