Lucio H. Kim DDS

Dental Insurance: WTH?

October 24, 2016
Posted By: Lucio H. Kim, DDS
Dental Insurance Simplification in Glendale CA, Dr. Lucio H. Kim, DDS

Any kind of insurance, medical or dental, is increasingly difficulty to navigate these days.  But we're here for you to help navigate the intentional maze that is called "dental insurance".

Interpreting Insurance

Basically there are 2 main types: HMO and PPO.  HMO or DMO assigns you a dentist that you HAVE to go to in order to use the dental insurance.  Some are OK, some are not so OK. The main reason is the business model with HMO insurances.  They are a volume and "upsell" game.  The more patients they have signed up with them, then the larger the check they get each month is.  Also, the more treatments that they "sell" that aren't covered by the insurance, then the bigger the bottom line.

This is where "business" really meets dental care.  If you can, avoid this one.  Unless you are 100% sure all you need are cleanings.  But even then, you can mess up on cleanings.  The next type of insurance is PPO.  This is where you have the freedom to go where you want and you still get coverage.  And this is the type you want to get if you are offered dental insurance through an employer b/c typically they have better coverage for less of a monthly premium.  

The maximum they cover each year is different...even with the same insurance company. It depends on what the HR department negotiated with them.  Also, the % coverage for procedures is different as well for the same reasons.  We've been "flossing" through the dental insurance game for almost 20 years so if you have any questions about your coverage, call the office and we can get your benefits for you and explain them in more detail. 

Call Your Glendale Dentist

It's "open enrollment" now, so if you don't actively choose a plan, usually the default is no coverage or an HMO type coverage...which you are stuck with until the next open enrollment period.  Get in touch with your HR and see what is available.


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