Many Canadians have a dental insurance plan through their employer, through a union, or through the federal government. However, they often have a lot of questions about what their plan covers and how it all works. Not understanding your dental insurance can make it stressful to visit the dentist or to switch to a new dental clinic. Westmount Dental Centre, a family dentist in Edmonton, has put together this FAQ to help you out.
1) What Treatments Does My Dental Insurance Cover?
Most standard dental insurance plans cover basic services such as teeth cleanings, fillings, dental examinations, and X-rays. More comprehensive plans may also offer full or partial coverage for treatments such as crowns, veneers, teeth whitening, and dentures in Edmonton.
To find out what exactly is covered by your plan, you should consult any and all available paper or online materials offered by your provider. If you are covered through your employer, then your employee benefits coordinator should have the pertinent materials. When looking over your plan, you should also take note of how much coverage you are allotted every year and what your co-payment is.
2) What is a Co-Payment?
A co-payment is the part of the dental bill that your insurance will not cover and that you will therefore be responsible for. For example, an 80/20 co-payment means that, for certain named procedures, your insurance will cover 80% of the cost and you will need to cover 20% of the cost. Basic procedures such as a teeth cleaning in Edmonton will usually have a lower co-payment.
3) How is Dental Insurance Coverage Determined?
Many dental insurance carriers determine treatment percentage coverage by referencing the Alberta Dental Association & College's Dental Fee Guide. This guide, however, does not always reflect what you will actually have to pay for a specific treatment. Likewise, it might not include procedures and fees for your specific treatment needs.
4) Can My Dentist Create a Treatment Plan Based on My Insurance Plan?
The main priority for all Edmonton dentists is to make sure you get the proper care. Your treatment plan will be based on your dental health needs, not on what your insurance covers. If your dentist provides you with multiple options, then you can ask about different cost estimates and possible treatment outcomes. Just keep in mind that your treatment decisions should also be based on your health care needs.
5) Can My Dentist Help Me Claim Benefits?
While not a guarantee for coverage, your Edmonton family dentist may be able to help you claim benefits for certain treatments by providing your insurance with a pre-determination. A pre-determination is essentially an outline of the proposed treatment plan, along with a cost estimate.
Have More Questions? Contact Westmount Dental Centre Today
As a West Edmonton dentist committed to providing dental care for people from all walks of life, Westmount Dental Centre will be happy to go over your available dental insurance options. We'll provide you with all the information you need to make important treatment decisions. Ready to start taking charge of your dental health? Contact us today to make an appointment with one of our Edmonton dentists.