Category Archives: Dental Insurance

Navigating the world of dental insurance can sometimes feel like deciphering a foreign language. With a myriad of terms and verbiage to understand, it’s no wonder many people find themselves confused when trying to make sense of their coverage.

By gaining a better understanding of key terms, you can empower yourself to make more informed decisions about your dental health and insurance coverage. In this blog, we’ll break down some of the most important terms you should know when it comes to dental insurance.

Key Terms Used in Dental Insurance

1. Premium: The amount you pay to your dental insurance company or third-party administrator, usually on a monthly or yearly basis.
2. Deductible: This is the amount you must pay out of pocket before your dental insurance kicks in. For example, if your deductible is $500, you’ll need to pay $500 for covered services before your insurance starts to cover any costs.
3. Covered Services: This refers to the specific treatments, procedures, and preventive care that are included in your insurance plan. These services are typically outlined in your policy and may vary depending on the type of plan you have. When you receive covered services, your insurance provider will pay a portion of the cost, as specified in your plan, while you may be responsible for copayments, coinsurance, or any amounts not covered by your plan.
4. Copay: A copayment, or copay, is a fixed amount you pay for a covered service, such as a dental visit or procedure. Copays can vary depending on the service provided.
5. Coinsurance: Coinsurance is the percentage of costs you share with your insurance company after you’ve met your deductible. For example, if your coinsurance is 20%, you’ll pay 20% of the covered expenses, and your insurance will cover the remaining 80%.
6. Annual Maximum: This is the maximum amount your insurance will pay for covered services within a plan year. Once you reach this limit, you’ll be responsible for paying any additional costs out of pocket.
7. Lifetime Maximum: Similar to the annual maximum, the lifetime maximum is the total amount your insurance will pay for covered services over the lifetime of your plan.
8. Coordination of Benefits: If you have more than one dental insurance plan, coordination of benefits determines which plan pays first and how much the secondary plan will cover.
9. Exclusions: These are services or treatments that your dental insurance plan does not cover. It’s important to review your plan’s exclusions carefully to understand what services you may need to pay for out of pocket.
10. Maximum Plan Allowance: This is the maximum amount your insurance will pay for a specific covered service. If your dentist charges more than the maximum plan allowance, you may be responsible for paying the difference.
11. Waiting Period: Some dental insurance plans have waiting periods before certain services are covered. It’s essential to understand any waiting periods associated with your plan to avoid unexpected costs.
12. Preauthorization: The process of getting approval from the dental insurance company before receiving certain dental treatments or procedures, often for more expensive or specialized treatments.
13. In-network: Dentists who have agreed to accept negotiated rates from the insurance company for covered services. Using in-network providers usually results in lower out-of-pocket costs for the insured individual.
14. Out-of-network: Dentists who have not agreed to accept negotiated rates from the insurance company. Using out-of-network providers may result in higher out-of-pocket costs for the insured individual.

Navigating Deductibles, Copayments, and Coinsurance in Dental Insurance Plans

Understanding how deductibles, copayments, and coinsurance work can help you manage your dental expenses more effectively. Here are some tips for navigating these aspects of dental insurance:

1. Understand how deductibles work. Take note of your plan’s deductible and plan your dental care accordingly. Consider scheduling routine check-ups and cleanings early in the year to help meet your deductible sooner.
2. Manage copayments and coinsurance for various services. Familiarize yourself with the copayment amounts for different services covered by your plan. Knowing what you’ll need to pay out of pocket for each service can help you budget accordingly.
3. Minimize out-of-pocket expenses. Take advantage of preventive services covered by your plan, such as routine cleanings and check-ups, to maintain good oral health and avoid costly treatments down the road. Additionally, consider using in-network providers as it will typically result in lower out-of-pocket costs.

Conclusion

Understanding dental insurance terminology is essential for making informed decisions about your coverage and managing your dental expenses effectively. By familiarizing yourself with key terms like deductibles, copayments, and coinsurance, you can navigate the complexities of dental insurance with confidence. Remember to review your plan’s coverage details carefully. Empower yourself with knowledge and take control of your dental health and insurance coverage today.

Visit the dental & vision insurance page to see current rates, review plan details, and enroll in minutes.

Lifelong oral health problems often begin in childhood, which is why it’s important to develop good oral health habits when your child is young. While there are many different types of dental issues, here are some of the most problematic to look out for in children:

Tooth Decay

This is the most common dental problem found in children. Baby teeth are especially prone to decay because they’re softer and more fragile than permanent teeth. Tooth decay occurs when acids and bacteria break down enamel and penetrate deeper layers in the tooth. This penetration leads to a cavity, which can then cause pain, infection, and if left untreated — an abscess formation.

According to a 2019 report from the CDC, 80% of children in the U.S. begin brushing their teeth later than dentists recommend. To prevent this problem, begin a twice-daily brushing regimen (using fluoride toothpaste) with your child as soon as their first tooth appears. It’s also important for parents to teach their kids to eat a balanced diet and avoid excessive sugary drinks and candy.

Pediatric Gingivitis / Gum Disease

Gum disease, also referred to as gingivitis or periodontal disease, is caused by bacterial infections and can lead to bleeding gums and bad breath. Children who develop gum disease may need antibiotics or other medications. The best way to prevent gum disease is with regular visits to the dentist every six months.

Broken Teeth and Grinding

From the playground to the soccer field to backyard hide-and-seek, children are prone to accidents — and are therefore more susceptible to breaking or chipping their teeth. A fractured tooth can be extremely painful, so contact your dentist right away if this happens to your child.

Surprisingly, teeth grinding often begins during childhood or adolescence. If you are seeing patterns of headaches, neck pains, jaw pain, or earaches in your child, they could unknowingly be grinding their teeth. If left untreated this can cause long-term damage to enamel and dentin, so let your child’s dentist know if any of these symptoms come up.

Thumb Sucking

Thumb sucking is one of the most common behaviors associated with early childhood. Excessive thumb sucking can have lifelong effects such as improper jaw alignment, overbites, crossbites, crowding of the teeth, malocclusion, and speech difficulties. If you notice your toddler excessively sucking their thumb, attempt to change their behavior by replacing it with pacifiers or finger foods such as carrots, celery, or apple slices (when they are old enough). If your child continues thumb sucking past age three, consult your dentist.

Dental Anxiety and Phobias

Some kids may experience extreme fear or anxiety over going to the dentist. This is normal but if it becomes too much, there are ways to help them overcome their fears. Scheduling regular checkups with your child’s dentist from a young age can help normalize the experience and ensure that any dental problems are caught and taken care of early on. It may also help to talk to them about oral health at home and set a good example by taking good care of your own oral hygiene.

Ready to take the first step on your family’s road to great oral health? Members have access to group rates on PPO dental plans! Visit our dental page to view plan details and enroll today.

Over the last year we’ve spent a lot of time focusing on staying healthy. We’ve washed our hands to the tune of happy birthday, worn face masks in public, and stayed home instead of going out. But when was the last time we focused on our oral health? Science has shown that problems that begin in our mouths can have an impact on the rest of our bodies.

But aside from daily flossing and brushing, taking care of our teeth and gums can be expensive. Dental insurance can help you cover the cost of keeping your teeth and gums as healthy as possible.

So, what else can dental insurance help you cover?

1) Emergencies

Dental pain is often a double-edged sword. There’s the physical pain – and for those without insurance – the pain of a hollowed-out wallet.

If you find yourself experiencing tooth pain, there’s a chance it is the result of something left unattended for too long and now requires major restorative work.

Most dental insurance plans offer deep savings on major restorative dental work and cover all or most preventative care which can help you avoid dental emergencies in the future.

2) Prevention

The American Dental Association recommends that you visit a dentist at least once a year for an exam and cleaning.

You may not always know what dangers could be just around the corner for you and your pearly whites—but a dentist can. Minor issues can lead to bigger and more costly ones down the road.

But the good news is that costly and painful dental problems can often be avoided with regular visits to a dentist and maintaining an oral hygiene routine at home.

3) Orthodontia Coverage

According to the Pennsylvania Dental Association, roughly 4 million people in the U.S. wear braces. But perfectly straight teeth can come at a hefty price.

The cost of dental braces can range anywhere between $3,000 and $10,000 (not including any other orthodontia services that may be required to help you achieve perfectly straight teeth).

And while not all dental insurance plans cover orthodontia, the ones that do can save you thousands, making you or your children’s path to a great smile a lot less painful.

Keeping Your Smile Bright

Dental insurance can help you and your family maintain your smiles for years to come. Tackle dental emergencies knowing you’re covered, address concerns before they become problems, and prevent future issues while saving on your out-of-pocket costs.

Visit our dental insurance page to see rates, review plan details, and enroll today.

The act of smiling is part of a universal language that everyone understands. When someone cries, they are sad or hurt; when someone laughs, they felt something was funny; and when someone smiles, they are happy or being friendly. No matter where you are in the world, a smile will always be welcomed and understood.

But could smiling have more health benefits we thought?

Health Benefits of Smiling

According to NBC News, “science has shown that the mere act of smiling can lift your mood, lower stress, boost your immune system and possibly even prolong your life.”

Smiling triggers the body to produce serotonin and dopamine resulting in an elevated mood. Not only are these chemicals part of the recipe for happiness, they may also play a part in boosting the immune system.

In one study, participants were separated into two groups, and both exposed to a virus. The first group was exposed to happiness-inducing stimuli and the second group was not. The results of the experiment showed that the group not exposed the happiness-inducing stimuli experienced higher infection rates than the other, leading some scientists to suggest that happiness can have an impact on one’s immune system.

This is just one study of many to suggest a link between those who are unhappy and those with weaker immune systems.

In addition to boosting immune systems, smiling has also been scientifically linked to:

• lowering heart rate
• lowering blood pressure
• longevity

What does your smile say?

Wouldn’t it be nice to smile with confidence? Whether you find yourself in need of costly dental repair or just a good bi-annual cleaning, as a member of the AMSA, you have access to unique savings on dental insurance.

With the Comprehensive PPO Dental Plan you have the freedom to visit any licensed dentist in the country and enjoy an annual max of $1,750. To learn more about the Comprehensive PPO Dental Plan or what other options are available to you as a member of the AMSA, visit https://amsa.memberbenefits.com/dentalvision/ today.

A trip to the dentist can be an extremely traumatic experience for children with developmental disabilities and special needs.

According to the CDC, recent estimates in the United States show that about one in six children aged 3 – 17 have one or more developmental disabilities. Additionally, many studies have noted that those who suffer with developmental disabilities also struggle with various stages of dental decay.

What You Can Do for Your Special Needs Child

Teaching your special needs child the fundamentals of dental hygiene can be hard — having a successful dental appointment can be even harder.

Once you find a dentist who can provide both the care and environment your child needs, there are steps you can take to minimize the stress your child feels by going to the dentist.

1. Schedule familiarization appointments.

Scheduling your child’s appointment ahead of time can help them adjust to their new surroundings. This will allow them to become more accustomed to the lights, sounds, and smells associated with a trip to the dentist’s office.

During these visits you can also meet with the dentist and their staff to help your child become more comfortable and less scared or nervous.

2. Tell stories leading up to the appointment.

Telling your child positive stories about visits to the dentist’s office in the weeks leading up to the appointment will help give them an idea of what to expect. It’s important that these stories emphasize a happy environment and not something associated with scary tools or pain.

3. Come prepared.

Does your child have a favorite movie or TV show? Bring it along on a tablet or phone so they can watch while they’re in the dentist’s chair. The distraction will help to focus their attention on the screen and not what is going on in their mouth.

4. Work with the office staff.

The staff at the dentist’s office is there to make sure your visit goes as quickly and smoothly as possible. Before the appointment, call the dentist’s office to see if the appointments are running behind and if you can sign in a little later. This will help you to minimize the amount of time spent in the waiting room.

The Right Choice for Your Family

Finding a dentist who can provide specialized care for special needs children can be very difficult. Depending on the severity of your child’s developmental disability, general anesthesia may be the only way to provide treatment — something that not all dentists are qualified (or equipped) to provide.

When was the last time your child took a trip to the dentist? Our Comprehensive PPO dental plan option gives your family the freedom to visit any licensed dentist in the country — or take advantage of savings when you visit one of over 135,000 preferred dentists and 32,000 specialists nationwide. Make your family’s oral health a priority by visiting amsa.memberbenefits.com/dentalvision/ today.

Need dental insurance for 2020? Apply by January 31st to receive coverage beginning February 1st!

According to American author William Arthur Ward, “A warm smile is the universal language of kindness.” Smiling is something we do instinctively as infants and something we carry with us all throughout our lives. Unfortunately for some, their smiles may not prove to be as warm and welcoming as they would hope. Problems such as gum disease, yellowed teeth, and chronic bad breath can have a negative impact when meeting new people and could be a sign of a deeper issue due to the close link between oral and overall health.

Many people learn the importance of oral hygiene at a young age. Those who don’t may face a variety of oral health problems down the road, some being scarier than others. So, what are some of the most common dental diseases?

1. Bad Breath

While some cases of bad breath can be the result of eating foods like onions, garlic, or hard-boiled eggs, other cases may prove to be more serious. Bad breath, otherwise referred to as, Halitosis, may be something that even a good solid brushing won’t be able to fix. Halitosis can be a symptom of larger problems such as gum disease, infection, dry mouth, or even other seemingly unrelated issues like gastric reflux, diabetes, liver or kidney disease. In some instances, Halitosis may even require a trip to your doctor.

2. Gum Disease

According to the Mayo Clinic, there are over 3 million cases of gum disease each year. And while gum disease, otherwise known as Periodontitis, may be common, that doesn’t make it any less serious. In fact, those with gum disease have a higher chance of developing diabetes, osteoporosis, heart disease and other ailments. In order to lessen your chances of developing gum disease, it is advised to practice good oral hygiene and schedule regular cleanings with your dentist, who may decide whether more preventative action is needed.

3. Yellow Teeth

While not exactly a disease, yellow teeth can be a sign of poor oral hygiene and can, in some cases, indicate other dental issues that may be lurking just beneath the surface. Visiting the dentist once every six months for a thorough cleaning can help prevent yellowing teeth due to diet or lifestyle choices. In some severe cases, veneers may be recommended.

4. Toothaches

A toothache should never be ignored. While some cases of a toothache may be related to minor inflammation, other cases could indicate the presence of gum disease, cavities, pulpitis, a broken tooth, or more. When confronted with a persistent toothache, the best course of action is to have a dentist find the underlying cause.

5. Tooth Erosion

There are few substances within the human body that are stronger than our enamel. This is why everyone from our dentists to television commercials are constantly urging us to protect it — because once our enamel is gone, it cannot be brought back. The loss of enamel is referred to as tooth erosion. Soda, sugar, and some acidic foods can eat away at our enamel. In order to combat the chances of experiencing tooth erosion, brushing with a soft-bristled brush is suggested as well as reducing the number of acidic drinks consumed.

Taking Control of Your Oral Health

When was the last time you visited the dentist? Could you be at risk of developing one, or even all, of these potentially costly dental problems?

Members can secure dental and vision insurance coverage for the whole family. Visit https://amsa.memberbenefits.com/dentalvision/ to learn more about what our dental and vision insurance plans can do for you.

If you and your family have been skipping trips to the dentist, you’re not alone. “For every adult without health insurance, an estimated three lack dental insurance” this comes according to a quote issued by the Kaiser Family Foundation based off of research conducted by the National Association of Dental Plans.

A Key Component Of Overall Health and Hygiene

But what so few realize is the close relationship between one’s oral health and their overall health. A person’s mouth is a haven for potentially harmful bacteria, regular flossing, brushing, and cleanings can keep the bacteria at bay but when a person is neglecting their teeth, the bacteria can build and lead to infections, tooth decay, and gum disease. From there, it is possible for the bacteria to enter the bloodstream and travel to other parts of the body leading to other serious problems.

You chose a dental plan that can help you save¹ and get the care you need.

No matter who your dentist may be, with the MetLife Preferred Dentist Program, the power to choose and save is yours.

Here are the facts: