According to the Health Policy Institute’s 2016 Oral Health and Well-Being in Washington survey, concern about dental cost is the biggest reason Washingtonians skip the dentist.
Cost doesn’t have to be a concern if you have dental coverage.
Here are three quick tips for using your dental coverage to get the most bang for your buck and decrease your dental costs:
1. Stay on top of your preventive dental visits.
The health of your mouth influences your body the same way an engine’s health affects how a car performs. Your dental coverage makes it easy to get the preventive care you need to keep your smile healthy.
Preventive dental visits include:
• Oral exam
• Fluoride treatment
Staying on top of your preventive dental visits helps avoid painful, expensive problems down the road. Plus, most of our plans cover these services at 100% so you have no out-of-pocket costs when you visit an in-network dentist.
2. Visit an in-network dentist.
In-network dentists are dentists who participate in your plan’s network. They provide services at discounted rates and file all claims paperwork for you. You get the best out-of-pocket cost savings when you visit an in-network dentist.
If you see an out-of-network, or non-participating, dentist, you’re responsible for making sure they file claims forms and send them to us. You’re also responsible for paying the dentist any amount above your plan’s allowed fees for services.
Here's how you can easily find out what network your plan uses:
• Create or sign in to your MySmile® account.
• On your dashboard, look at your member ID card.
• It's right there!
Looking for a dentist? We have two ways for you to find one. Use our public Find a dentist tool and be sure to select your plan's network. OR, sign in to MySmile and use its Find a dentist tool. It automatically selects your plan's network so you don't have to.
3. Understand your dental benefits and coverage levels.
You can view your coverage by creating or signing in to your MySmile account and selecting “Coverage overview.” Coverage levels, the percentage your dental plan pays, are listed by service. They’re further broken down by network.
Here’s what each of the network terms means:
• In-network applies to any dentist who participates in your plan’s network.
• Out-of-network applies to any dentist who doesn’t participate in your plan’s network.
• Out-of-service area applies to certain plans that use regional networks. With these plans, out-of-service area means the dentist does not belong to that regional network.
Here are key things to look at:
• Plan pays refers to the percentage your dental plan pays towards that service. The percentage level listed is the percentage your plan pays towards the service. If it says 100%, then your out-of-pocket cost is $0 when you see a dentist in that plan’s network.
• Waiting period refers to any amount of time you have to wait before your plan pays towards that dental service. If you receive the service before the waiting period, you may be responsible for the full cost.
• Deductible is any amount of money you must pay towards that service before your plan pays. It’s kind of like the buy in at a poker game.
Taking the time to understand how your dental plan works really helps eliminate cost surprises at the dentist's office.