Navigating Your Dental Benefits Plan

I know how difficult it can be to navigate your dental benefits plan. The cynic in me thinks that some companies make it as difficult as possible to understand how much coverage you are actually entitled to so that you just pay out-of-pocket, or go without. However, the key word here is entitled! You are entitled to receive the best health care possible under your plan and should take strides to educate yourself and ensure you are optimizing your coverage for all your wellness needs.

Here’s a look at the dental and periodontal industry by the numbers:

• $8.1 Billion: The amount paid out to Canadians with dental insurance in 2017-18*
• 9,000,000: The number of Canadians who do not regularly visit a dentist.**
• 30,000: According to the Dental Association of Ontario, this is the number of dental plan contracts in Ontario… and each one is a little different from the next.
• 33%: The number of Ontario employees without medical and dental benefits through their workplace according to a study by the Wellesley Institute, a Toronto-based health policy think-tank.
• 21%: The number of adults who have had moderate to severe periodontal disease**

Most dental benefits plans allow for one regular dental visit every 6 to 9 months. However, there are some plans that allow you to add periodontal visits / services more frequently than that. For those with proven chronic gum disease, there may be allowances for more frequent cleanings by a periodontist. From what we understand, those with benefits from car companies, have these flexible benefits.

If you can maximize your dental visits and fast-track your cleaning schedule, it’s worth the ask. 

Remember, your dental benefits plan should never dictate your dental treatment. Your treatment plan is designed to optimize your dental health and is not dictated by your coverage. Working with your periodontal team in Mississauga can help you understand how to maximize your benefits.

Some questions you should ask your dental plan provider, if you haven’t already:

• What dental coverage am I covered for each year?
• Is there a deductible… do I have to pay out-of-pocket first?
• How much coverage do I have available for cleanings and x-rays? Can I choose to see a periodontist for deep cleaning rather than my traditional dentist and will that be fully covered?
• Am I covered for dental treatments such as fillings and root canals? What percentage is covered and is there a maximum?
• Do I have additional coverage for more detailed dental work, such as bridges and crowns, dentures and oral surgery?

If you are uncertain how to approach the conversation with your insurance company, our team can help. We have decades of experience communicating with all insurance providers and can easily reach out to help you find the answers you need.

Your comfort matters to us, so we invite you to visit our periodontal practice in Mississauga and speak with our team of experts in periodontal disease. As experts in periodontal treatments, specializing in dental implants, gum recession, crown lengthening, bone and gum grafting, the Chao pinhole surgical technique and more, we’d love to help you address your dental and smile concerns. Call us at 1-800-341-7471 or connect via email at mail@paperio.ca. Until then… keep smiling!

Source:

*http://clhia.uberflip.com/i/1030763-canadian-life-and-health-insurance-facts-2018/17?

**Canadian Health Measures Survey results – Oral health statistics, 2007-2009