The staff at my dentist's office gave me something to think about yesterday. They told me that they would be leaving the preferred provider network for the dental insurance company I'm currently using. Staying in the preferred provider network was costing them too much money, so they're pulling out as of December 1st.
This was a nice gesture. They didn't have to do that. They volunteered the information. This was a lot more than my previous dentist did.
I didn't talk for very long with the staff about why they were leaving, but the end result is that the covered amount for services I had been getting will go down after December 1st. Initially I was disappointed, since this was the very reason I had gone to this dentist. He's provided me with excellent service (even to the point of driving up on a Sunday to look at my cheek which had gotten infected after a root canal). But my previous dentist was excellent as well; the reason I left was because she didn't accept any insurance that would reduce the big expenses (crowns, root canals, etc.) at all. It wasn't a matter of service. It was a matter of money. In the best of all worlds money wouldn't matter, but it does.
Fortunately, I have time to investigate other options without looking for another dentist. Open season for my insurance selection is coming up within the next couple of months, and the dentist's staff has already given me a list of insurers for which they will be in the preferred provider network.
Here is a list of things to check when investigating your health and dental insurance coverage:
- Look at your overall health and your oral health. Are you in good shape, or do you know that you'll have to have a lot of work done? For example, my teeth suck. I need coverage for big expenses because many of my teeth already have had minor restorations done to them. It only gets worse from here for me. My wife, on the other hand, can still afford to go to my old dentist. She's had hardly any dental work done.
- Ask the doctors and dentists what networks they are in and whether they will be continuing this relationship. The key part is “ask the doctors and dentists.” Don't depend on the provider list available from the insurance company. Don't depend on the website. Get it straight from the horse's mouth, because the other sources could be out of date. Also, be sure to ask specifically about their preferred provider networks, not just whether they take the insurance or not. That was the mistake I made with my last dentist.
- Now that you have choices, check the coverage on the insurance companies' ends. Specifically, do they cover the services you need to have covered? Is there a waiting period for any of the services? In other words, do you have to “pay in” to the insurance before claiming any big expenses? What is the maximum coverage? What is the deductible? What is the co-pay?
- Verify your findings with the doctor's office / dentist's office. If there's a mismatch, find out why before you start treatment. Usually the insurance has to be in force when treatment commences for them to pay anything.
The matches are out there, but it requires a bit of planning to take advantage of them. (Or a little good fortune, as happened to me.)
