Dental Insurance
Dental Insurance Demystified
All Dental Plans Are Not Created Equal...
Not Even Close
As an Independent Agent, I offer a variety of dental plans to fit different situations my customers find themselves in. These situations include compatibility with certain Employer provided medical plans, competing with the Af**c duck mascot plan, some work with Medicare and some stand alone.
In my experience there is only ONE (1) plan, that I am aware of, that works in all these situations. It checks all the boxes and when Customers compare it to other plans, from any source, they usually come back to what I refer to as My Best Plan.
After you take a look at the plan highlights please drop a line in the ""Have a Question" area below and share your thoughts either way.
Plan Highlights
In no particular order My Best Plan includes, but is not limited to, these benefits and much more:
- Three (3) Annual Plan Benefit Levels: $1500, $3000, $5000 and a soon to be released $7500 plan.
- Multple Plan Designs: Member only, Member Plus Spouse, Member & Children and Family.
- All Plans Are PPO's which means No Referrals Required for Specialists like Periodontists or Oral Surgeons.
- My Best Plan covers IMPLANTS (all 4 stages of the procedure,) CROWNS and DENTURES as Major Services with no "gotchas." Read the next section for examples of gotchas.
- Cover Preventative Services at 100% with no waiting period, Basic Services at 80% with no waiting period & Major Services at 50% with a one (1) year waiting period.
- This one (1) year waiting period is entirely or partially waived if:
a) Member provides proof of previous creditable coverage.
b) My Best Plan gives credit for months a member was waiting for Major Services coverage on their old plan, example: If a members old plan makes them wait one (1) year for major services and the member has been waiting for six (6) months then My Best Plan will only require a new member to wait six months. We pick up where the other plan leaves off. - My Best Plan stands alone or coordinates with Any Other Plans.
- My Best Plan pays the same benefit regardless of whether your dentist is In Network or Out of Network.
- A Generous "Stacked Network" of 260,000+ providers in our network. Our stack includes: a) Carrington, b) Dentamax, and c) Connections Dental. Stacked means if you are in one of these three (3) plans, then ALL the dentists in the other two (2) plans are automatically In-Network which is truly awesome.
- And much more...
So What Are The "Gotchas"
My Best Plan keeps things simple. If a procedure is covered, it's covered, without any special language to limit a member's plan benefit.
Many dental plans have clauses in their plan documents that are designed to limit the financial exposure the dental plan has to pay to any particular member in any single plan year. This is how they keep their rates down.
Some of these clauses are:
- Stated benefits not truly covered: Of the plans that say they cover IMPLANTS, DENTURES, etc many only cover PART of the procedure. Example: IMPLANTS have four (4) steps to the procedure:
1) Extraction of the bad tooth
2) Bone graft to attach the implant to, if required. (Usually never covered by plans.)
3) Abutment which is the connection between the screw and the tooth/Implant. (Not normally covered.)
4) The tooth/Implant itself.
*Some plans only cover Step 4.
With My Best Plan there are no hidden clauses to deny claims. If we say it covered, it's covered. Period. - Family Maximums: Plans may advertise a high benefit per covered member but then add a Family Maximum. Example: If a plan offers a $5000 annual member maxium in a year and adds a Family Maximum of $7500 then, in a family of 4 the first person may need the full $5000, the second person may use $2500 and boom, the family is at the maximum. There are no benefits left for the other 2 family members if services are needed.
- And more...
What's the Post Office Rule?
No it's not a game children play. The US Postal Service provides members of My Best Dental Plan indirectly with UNMATCHED access to quality dental care because:
- The US Postal Service uses Connections Dental as their PPO Network and has for many years.
- Connections Dental is in our Stacked Network.
- The Post Office Rule states that at least one (1) Connections Dental PPO Dentist (In-Network) must be located within a couple miles of every US Post Office location across the entire country. This means that you can basically roll out of bed and get to a great dentist who provides In-Network benefits even in rural areas of our country.
This is how the Buckley Agency demystifies dental insurance.