It is a well-known fact that medical and dental bills can add up quite quickly, even if such expenses are simply for quarterly prescription refills and semi-annual trips to the dentist for x-rays and a cleaning.
This is why dental insurance coverage offered by private and provincial health care plans is seen as such a considerable benefit, regardless of whether the subsidy is a full 100 percent or capped at a pre-determined level.
But what happens when medical expenses are unplanned or unexpected, such as an injury or accident that happens while in a car wreck? If such a mishap happens to involve your permanent teeth, treatment costs can be very high and may not be covered by your insurance plan.
There is a common belief that dental insurance is all encompassing, especially when many claims are limited to basic requirements like cleanings, fillings, or the rare tooth extraction. Most plans also plainly stipulate the limits for orthodontic treatment, since it is not considered as normal care for all plan members. As a result, and based on this limited degree of knowledge about their plans, people are often unaware of the percentage or actual dollar amount that they will need to pay when they use these services.
Accidental Dental Coverage
Were you aware that most health care benefits packages contain an accidental dental benefit? This is in addition to your regular dental benefits and is often covered under your health care package. Accidental dental, covers most dental treatment at 100 percent even if it falls within the realm of major treatment such as crowns and bridges.
In the case of an accidental injury, an accidental dental claim form must be submitted from you as well as a report from your dentist after the accident. Accidents can be as harsh as falling down stairs or as minimal as biting into a chicken bone. By using up this coverage you do not use up your normal dental benefits and therefore saving your regular coverage for other dental services you may require.
It is important to remember that insurance is designed to protect you in a worst-case scenario. Dental insurance is significantly different from most other kinds of insurance, like health insurance or car insurance, because the potential downside is fairly low. Today there are many dental insurance providers, each offering a variety of policies and services, with different fee schedules.
You have a contract with your dental Insurer, and any differences between regular dental benefits are divided into two distinct categories:
- Basic Procedures: Includes Exams, X-rays, Cleanings, Restorations, Extractions and Root Canals (there are usually limitations on the amount of Periodontal Scaling, or Cleanings, allowed).
- Major Procedures: Includes Crowns, Bridges, Veneers, Inlays, Onlays, Implants, Partial Dentures and Full Dentures.
Your Dental Insurance will either have separate coverage amounts for each group or one amount for all services combined.
It is always recommended to have a pre-approval sent by your dental provider for major services to ensure coverage and be aware of any balances before scheduling your appointments. This information is usually sent to the patient from their insurance provider.
The Alberta Government does have dental assistance for senior citizens. It is necessary to apply for these benefits and your coverage level is dependent upon your annual income.
Note: Policies vary so please check your specific coverage.
Are you looking for a dentist? Well, new patients are always welcome at Dr. Jason Harvey’s office. We pledge to treat you with the same respect and care that we do for each of our valued clients.