Your Guide Through Dental Insurance Terms

Dental Health
By: Spirit Dental
June 28, 2015

Multi-colored sticky notes n a whiteboard

The insurance industry is one of the sectors whose understanding has eluded many. Insurance policies are usually filled with insurance jargon that provides little or no definitions. Just like with legal matters, individuals are forced to depend on insurance agents to guide them through application, payment, and filing for claims.

The terms used for each insurance policy taken by an individual will vary greatly depending on the particular policy. As such, there is no way of generalizing the terms used in insurance. This article attempts to provide an insight on some of the terms pertaining to dental insurance.

By equipping the reader with such information, they will be better placed to know exactly what they are signing up for. The common terminologies include:

  • Dental insurance – this refers to an insurance policy that provides financial assistance to covered patients for all medical expenses that result from dental treatments.
  • Dependents – these are the other beneficiaries of the insurance policy undertaken by the applicant. Their names are usually required during the application process.
  • Diagnostic care – this refers to all the processes that are performed to determine the actual dental issue. They include X-rays and physical exams.
  • Effective date – this is the date that signifies the start of your dental insurance cover. One is entitled for benefits from this date henceforth.
  • Endodontics – this refers to dental treatment procedures that target the root canal and the dental pulp.
  • Exclusions – this refers to dental treatments or procedures that are not covered by the dental insurance plan. As such, one is not entitled for benefits and will incur the full costs.
  • Extraction – this refers to procedures that are involved in the extraction of teeth or a tooth from the surrounding tissue.
  • Family deductibles – this refers to the total sum that is remitted to the insurance provider for obtaining cover for the entire family. The sum should be sufficient to cater for all the expenses that may be incurred by any family member.
  • Fee schedule - this refers to a pre-determined treatment fee for dental conditions that is set by the dentist for each service they provide. It helps give an overview of how the deductibles or premiums may be calculated.
  • Filing – this refers to the materials that are used to fill tooth cavities. They may include gold, silver, copper amalgam among others.
  • Gingivitis – this refers to a dental condition where the gums become inflamed.
  • Implant – this is a device that is surgically attached to the jaws to provide support medium for dentures, crown or dental bridge.
  • Allowable charges – this refers to the amount that is entitled to you for particular dental treatments. Amounts exceeding this charge are not covered.
  • Beneficiary – this is the person who has undertaken a dental insurance policy or any other person that is entitled for financial assistance from the insurance provider.
  • Carrier – a carrier is the company that provides or sells dental insurance.
  • Deductible – this is the amount of money that the insured needs to pay within the duration of the contract for them to be entitled for cover.

These are just some of the dental insurance terms that one needs to know of.

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