Month: June 2024

Wenatchee Insurance, we work with a variety of companies to find which plan works best for the client. Some have waiting periods which is why we like to review plans with clients before they buy them.

Dental insurance works kind of like having a quirky best friend who sometimes covers your tab and other times makes you pay your own way. Let’s break it down:

Types of Dental Insurance Plans

1. Preferred Provider Organization (PPO)
   • Description: Imagine you have a favorite pizza place, but you sometimes cheat with other pizzerias. PPOs let you see any dentist, but you save more if you stick with the plan’s favorite pizza… er, dentist.
   • Pros: More freedom to cheat on your dentist.
   • Cons: Your wallet might feel the betrayal if you go out-of-network.
2. Health Maintenance Organization (HMO)
   • Description: This is like having a strict diet plan where you can only eat at certain places. HMOs make you stay within the network, or else!
   • Pros: Your wallet stays on a strict diet.
   • Cons: Less freedom to indulge in dental decadence.

Coverage Categories

Dental insurance likes to categorize things because, apparently, it’s very organized. Here’s the scoop:

1. Preventive Care
   • Examples: Routine exams, cleanings, X-rays.
   • Coverage: 100% covered because who doesn’t like free stuff?
2. Basic Procedures
   • Examples: Fillings, extractions, periodontal treatment.
   • Coverage: They’ll cover 70-80%, which means you’re still paying a bit, but hey, it’s better than footing the whole bill.
3. Major Procedures
   • Examples: Crowns, bridges, dentures.
   • Coverage: Only 50%, because apparently major procedures are the fancy, designer shoes of the dental world.

Key Features

1. Premiums
   • Description: The monthly or annual fee you pay just to be part of this exclusive dental club. Think of it as your ticket to the show.
2. Deductibles
   • Description: The amount you pay out-of-pocket before your insurance says, “Okay, now I’ll help.” It’s like having to eat your veggies before getting dessert.
3. Copayments and Coinsurance
   • Description: Your share of the costs for covered services. It’s like going Dutch on a date – you both chip in.
4. Annual Maximum
   • Description: The max amount the insurance will pay in a year. Once you hit that, it’s like the insurance saying, “I’m tapped out, buddy. You’re on your own.”
5. Waiting Periods
   • Description: The time you have to wait before certain procedures are covered. It’s like a countdown to Christmas, but less exciting.
6. Network Restrictions
   • Description: Some plans require you to use specific dentists. It’s like only being allowed to shop at one store for all your dental goodies.

Example Dental Insurance Scenario

Let’s say you have a PPO plan with:

• A $50 deductible (the price of admission).
• 100/80/50 coverage (the friend who’s sometimes generous).
• And a $1,500 annual maximum (the friend who’s great until they run out of cash).

For a routine cleaning:

• Cost: $100
• You pay: $0 (because preventive care is like the free bread at a restaurant).

For a filling:

• Cost: $200
• You pay: $40 (20% coinsurance after the deductible, like tipping the waiter).

For a crown:

• Cost: $1,000
• You pay: $500 (50% coinsurance, because crowns are fancy).

So, there you have it. Dental insurance is like having a sometimes generous, sometimes stingy friend who helps you out with dental bills but also makes you chip in and follow some quirky rules. Enjoy the ride, and may your teeth be ever shiny!

We can add dental insurance year round at Wenatchee Insurance.