Chew on this: Den­tal cov­er­age gives pro­tec­tion within lim­its

Kuwait Times - - HEALTH & SCIENCE -

Don’t for­get about your teeth when you start con­sid­er­ing 2018 in­sur­ance needs later this fall. The an­nual sign-up win­dow for many types of health in­sur­ance also is a good time to think about den­tal cov­er­age. Many em­ploy­ers of­fer a chance to sign up for it dur­ing their open en­roll­ment pe­riod for ben­e­fits. Den­tal pro­tec­tion also can be pur­chased with pri­vate Medi­care Ad­van­tage cov­er­age or through the Af­ford­able Care Act’s pub­lic mar­ket­places. There’s a big mar­ket for it. About 74 mil­lion Amer­i­cans have no den­tal cov­er­age, ac­cord­ing to the Na­tional As­so­ci­a­tion of Den­tal Plans. That’s around 23 per­cent of the pop­u­la­tion, or more than dou­ble the per­cent­age that lacks health in­sur­ance. Here are some things to con­sider when shop­ping for den­tal plans.

Peo­ple lack den­tal cov­er­age

The main rea­son is lim­its on govern­ment health pro­grams. Medi­care pro­vides health cov­er­age for peo­ple who turn 65, but the fed­eral pro­gram of­fers no den­tal op­tion un­less you buy it through pri­vately-run Medi­care Ad­van­tage plans. Like­wise, den­tal cov­er­age is spotty for adults in Med­i­caid, the fed­eral-state health in­sur­ance pro­gram for the poor. Shop­pers also can­not use tax cred­its to help pay for most adult den­tal cov­er­age sold on the ACA’s mar­ket­places or ex­changes.

What should I ex­pect?

You won’t have to pay for pre­ven­tive care like teeth clean­ings. Your in­surer also will grab the bill for the oc­ca­sional X-ray. Cov­er­age tends to shrink from there. Ba­sic work like cav­ity fill­ings might come with coin­sur­ance, which re­quires you to pay a cer­tain per­cent­age of the bill. That co-in­sur­ance may be as high as 50 per­cent for ma­jor work like crowns or den­tures. Many plans also pay only $1,500 or less an­nu­ally for care per per­son. Af­ter that, the cus­tomer has to pick up the rest of the cost. Cov­er­age for a kid’s braces also may be lim­ited to a max­i­mum life­time pay­ment of $1,000 per per­son, de­pend­ing on the plan.

Why are there lim­its?

Den­tal cov­er­age is de­signed to en­cour­age peo­ple to get reg­u­lar care that keeps tooth de­cay and other costly prob­lems from de­vel­op­ing. “The idea is you pay more out of pocket if you let things go south,” said Eve­lyn Ire­land, ex­ec­u­tive di­rec­tor of the Na­tional As­so­ci­a­tion of Den­tal Plans. If the in­surer cov­ered more, then pre­mi­ums would rise, and that might dis­suade peo­ple from get­ting reg­u­lar den­tal check­ups, Ire­land said. The den­tal plans as­so­ci­a­tion es­ti­mates that more than 90 per­cent of pa­tients do not hit their plan’s an­nual max­i­mum. How­ever, re­search sug­gests that some peo­ple start avoid­ing care be­fore they reach their plan’s lim­its due to the costs they face even with cov­er­age, said Marko Vu­ji­cic, chief econ­o­mist for the Amer­i­can Den­tal As­so­ci­a­tion’s Health Pol­icy Institute.

Should I bother buy­ing cov­er­age?

The an­swer can de­pend on whether you ex­pect to need more than ba­sic care and if your den­tist of­fers a dis­count pro­gram. Pa­tients can use tax-ad­van­taged health sav­ings or flex­i­ble spend­ing ac­counts to cover den­tal bills. Con­sider how your pro­jected ex­penses com­pare with the monthly pre­mium you’d pay for cov­er­age and whether you have the re­sources to han­dle an un­ex­pected bill of $1,000 or more. Monthly pre­mi­ums can top $50 for a fam­ily plan, which is much less than a typ­i­cal health pre­mium. Your em­ployer likely will pay some of that for any plan pur­chased through work. — AP

SOUTH BEND, In­di­ana: In this file photo, Dr Sheena Zent re­places a fill­ing for a pa­tient in South Bend, Ind. —AP

Newspapers in English

Newspapers from Kuwait

© PressReader. All rights reserved.