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Understanding Out-of-Pocket Costs

April 11, 2017 By Sara Fossum

Understanding Out of Pocket Costs

Dental benefits are designed to help save you money, but you may have to pay additional expenses outside your monthly premium depending on your coverage.

These out-of-pocket costs encompass any payment that your insurance provider doesn’t cover. Here are 5 things that factor into out-of-pocket expenses:

1. Coverage:

Dental coverage depends on your plan’s specific design. Some treatments may be covered in full, some may be partially covered and some may not be covered at all. Additionally, if you see a dentist who is out-of-network, your benefits may not provide as much coverage.

Log into your account to learn specifically what your benefits do or don’t cover.

2. Deductible:

A deductible is the amount you’ll pay for treatment before your dental benefits provider begins to start paying for treatment.

3. Coinsurance:

Coinsurance means your dental benefits provider will pay for a percentage of covered treatment costs, and you will pay the remainder.

4. Copayment:

Some treatments require a fixed amount to be paid upfront, before treatment is received. Because your copay is predetermined beforehand, it will stay the same, no matter how much the dentist charges.

5. Annual Maximum:

Most dental plans have a yearly maximum dollar amount for all covered treatments. If you’ve exceeded your annual maximum, you will be responsible for all treatment expenses until your plan resets the next year.

Have questions about your plan? Feel free to reach out to us on Facebook or Twitter!

 

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