Dental & Medical Insurance

Dental and medical insurance are necessities in today's society. The high cost of health care makes any type of routine or medically necessary treatment a hardship for many households. Although insurance sometimes is expensive, it can prevent financial disaster in an emergency.

Purpose

• Premiums are paid on a regular basis.

  Dental and medical insurance is purchased to pay a portion, if not all, of a dental or medical service. It can be thought of as a savings plan. Customers pay the insurance company a certain amount on a regular basis, called a premium. This money is to be paid out to a health care provider at a later date. Insurance carriers sometimes must pay out more if covered services require a larger amount than premiums paid.

Deductibles

• Deductibles for prescriptions, dental and medical services usually are seperate.

  A deductible is an amount that the insurance plan holder must pay in dental and medical bills each year before the insurance company begins to pay for health care services. Usually the higher the deductible, the lower the customer's premiums.

Co-Payments

• Commonly, insurance companies pay 80 percent of regular services.

  Insurance companies usually do not pay for a service in full. It is common for the customer to pay a small percentage until a maximum out-of-pocket amount has been reached for the year. This is called a co-payment. The most common co-payment is 20 percent of the total bill. After the out-of-pocket expenses have totaled the policy maximum, the insurance company will pay 100 percent of the dental or medical bills for the remainder of the year.

Claims

• Insurance can reduce your dental and medical costs.

  Dental and medical claims usually are filed by the health care provider's office. A claim is a bill sent to the insurance company outlining the procedure and diagnosis treated. The insurance company decides if the procedure is covered by their customer's policy or not, and pays or denies the claim based on the information provided. If a claim is denied, it is the customer's responsibility to pay the health care provider in full.