5 Tips for Choosing the Best Dental Plan

Posted on August 1, 2011 by Wanda

Dental Insurance in Raleigh, NCUnlike most people I enjoy going to the dentist. As a child I had a dentist who knew how to entertain his patients while performing dental procedures that were usually painless.  When my dentist retired his son took over the practice and continued the family tradition of making the patients feel at ease.  It’s good that I have always had access to exceptional dental care since I was not blessed with good teeth. My numerous childhood fillings resulted in a lot of crowns and root canals as an adult.

Fortunately my personal experience has helped me understand the important features of good dental plan and how to assist my clients in evaluating these plans. Here is my advice for buying dental insurance:

  1. If you are leaving your current employer and have a dental plan that fits your needs, your best option might be to take the dental part of COBRA.  Even if you do not take the medical part of COBRA, you normally can accept the dental and stay on it for 18months.  The monthly premiums might be lower than your other options.  If you have a child who needs braces and your current plan offers Orthodontia, you should stay on this plan. Dental plans that individuals purchase do not include Orthodontia.
  1. Most dental plans cover 100% of the cost of your cleanings.  However, they normally have 6 month waiting period before they cover basic services such as fillings, extractions, oral surgery and root canals. For major services such as crowns and bridges there is often a 12 month waiting period. When you leave a dental plan they provide a Certificate of Coverage showing the start and end dates of your dental coverage. Some dental plans will waive these waiting periods if you can provide a Certificate of Coverage showing that you have not had a break in dental coverage of more than 63 days during the past 18 months.
  1. Check to see if your dentist is in the plan’s network and ask questions about how the plan will pay if she/he is outside of this network.  Since your dentist will probably not be able to perform all procedures such as root canals and oral surgeries, it is also important to know if specialists such as oral surgeons and endodontists are in the network in your area.
  1. Understand the cancellation policies and initial enrollment costs of all the plans you consider.  Initial enrollment fees and a 12 month requirement to remain on the plan are not a problem if you are a retiree or self employed individual who expects to be on the dental plan for a long period.  However, if you are between jobs and expect to land a job within a few months with dental benefits, this could be a problem.
  1. When you do your cost comparison don’t just consider the monthly premiums. Also compare deductibles, yearly maximums and percentages that each plan pays for various procedures.
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8 Tips for NC Residents who have been declined for Health Insurance or have Pre-Existing Conditions

Posted on November 26, 2010 by admin

Individuals who have spent most or all of their lives on group insurance are often surprised when they have to go through underwriting (the process of reviewing one’s medical records) as part of the individual health insurance application process. After … Continue reading →

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Six Tips for Finding the Best Health Insurance Deal

Posted on August 14, 2010 by admin

Whether your health status is healthy, high risk or somewhere in between, these tips will help you find the best deal. This is a wealth of information and resources designed to transform the first time health insurance shopper into an educated consumer.

Explore your options with an agent who represents several health insurance companies and can help you make comparisons. There is no charge for this service and it can save you a lot of time and aggravation. Once you have educated your agent on your budget, expectations and pre-existing medical conditions, he/she can advise you on the policies and insurance companies that would best fit your needs.  For quotes from several top insurance companies or additional information, Click Here.

Don’t wait until the last minute to do your research and apply for insurance. This is probably the best way to make sure you get the best possible deal.  Individuals who have spent most of their lives on group insurance are often surprised that purchasing their own policy requires them to go through an insurance company’s underwriting and be accepted.  Underwriting is the insurance company’s process of reviewing an applicant’s medical records and application to determine if that individual is acceptable for coverage.  Insurance companies are very different in how they evaluate their applicants. I’ve had clients that were declined by one company receive the “preferred” rate with another company.  In case you run into unexpected problems, delays or choices, it is to your advantage to begin this process at least 45 days before you need new insurance.

Understand the following 3 insurance terms:

Deductible – Dollar amount of medical expenses you pay before your insurance covers you.

Coinsurance – After the deductible this is the percentage the insurance company must pay.  For example, if your plan is an 80/20 this means the insurance company must pay 80% and you must pay 20%.  It is important to purchase a plan that has a limit on the dollar amount you are required to pay.

Co-payments – Fixed dollar amount you pay for a doctor visit, emergency room visit or a prescription drug.

More details are available at the N.C. Department of Insurance web site www.ncdoi.com.

If you have children who are 18 or younger and your income for the past year is low, your children may qualify for reduced or free government sponsored health insurance. For additional information contact the NC Division of Medical Assistance at 800-367-2229 or www.nchealthystart.org. your children are attending a college or university contact their Student Health Services and request information on their student health insurance plans.  Universities or colleges may have health insurance policies that are less expensive than adding them to your plan.If

Consider purchasing an IRS-Qualified High Deductible Health Plan (HDHP).

Purchasing one of these policies can reduce your monthly premium by 50% or more.  This is a perfect solution for healthy people who rarely go to the doctor.  These HDHP’s can be paired with a Health Savings Account (HSA) that offers additional savings by reducing your taxable income. Unlike the traditional health insurance plans, the policy holder pays for all medical expenses until he reaches his deductible. Like traditional plans, HDHP’s have a wide range of deductibles, coinsurance options and benefits.  .

If your health problems cause you to be declined or your premiums are not affordable for health insurance in the private sector, consider Inclusive Health. Created by the NC General Assembly in 2007, this state government sponsored insurance first began accepting applications in the fall of 2008 for an effective date of January 2009.  Your premiums are based on your age, gender and whether or not you smoke. Inclusive Health does not decline or “rate up”(increase the premium) due to the applicant’s health. They recently began offering a Federal Option for individuals who have been without health insurance longer than six months.  More information is available at www.inclusivehealth.org or 866-665-2117.

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