We explore some of the most common concerns about dental insurance policies for self-employed Americans including whether it is worth it to protect your teeth and the cost and difficulty of obtaining coverage. This issue was brought to light in part by a group of high school students who were given an opportunity to travel from their rural home state to attend college in America’s “most expensive city” (New York), with no money to cover any emergency medical care. As such, they had little choice but to rely on help from family members, friends, and strangers.
As a result of this problem many dentists have started offering limited coverage for low income people, many of whom are unaware of their right to affordable care until after they return home. Even if you are insured through an employer’s employee plan, you may still only receive limited coverage due to the lack of an individual dental plan provided in most cases by government agencies. However, there are options available for individuals seeking more extensive coverage, especially if you work in fields where the risk of dental disease can be higher or if you pay premiums for regular visits to your dentist. If you’re interested in learning more about the full range of benefits that come with dental healthcare, read our article covering everything you need to know about insurance.
In this article, we review what dental insurance for self-employed people is and how much coverage is possible based on each person’s personal risks and health. We also provide some tips for choosing a private dentist, as well as information about getting and paying deductibles and co-insurance. While not everything covers every situation, a few things should always be covered regardless of the type of treatment you choose. The purpose of this article is to acquaint you with the various types of coverage that exist for employers offering business health plans as well as providing additional assistance with purchasing these plans. Since employers sometimes offer other kinds of insurance as well, this isn’t intended to serve the interests of those employees.
What Is A Basic Health Insurance Policy?
The simplest way to think of health insurance policies is as simply providing financial assistance for medical needs at a price that is lower than the costs of care itself. It’s very likely you will never use all the services you get reimbursed for, but it’s necessary if any problems arise and the amount required may exceed your budget. Generally speaking, if you have no health problems you do not require any insurance cover. In most cases, however, you should consider having some form of coverage, even if it comes at a premium. Let’s look at some examples:
If you have been diagnosed with cancer or heart disease, it’s likely you will need to pay more for treatment, which doesn’t include routine checkups or preventive measures, than someone without similar conditions. Your doctor, likely your primary care provider (PCP), and your insurance carrier may provide guidelines about how big a bill might be. You should also make sure everyone knows that you need adequate health care coverage if you become disabled, must leave work, or become unable to make ends meet because of your illness. When you purchase insurance you need to understand that the cost of care will vary depending on the circumstances. To get a better idea of how much the monthly cost of insurance will probably impact your budget compare dental insurance quotes for yourself online or speak with a licensed insurance agent who knows about this kind of coverage. Most plans offered for business owners fall into one or two categories: Individual coverage — covers your entire household directly, while Group health insurance — is meant to be paid by others. There is usually an annual deductible, which typically ranges from $100 for younger adults to $1000 for middle-aged or older adults. Some plans don’t have a single deductible but rather various amounts based on the number of people in a household.
— covers your entire household directly, while Group health insurance — is meant to be paid by others. There is usually an annual deductible, which typically ranges from younger adults to middle-aged or older adults. Some plans don’t have a single deductible but rather various amounts based on the number of people in a household. Specialty coverage includes things like vision, hearing aids, and eyeglasses; prescription drugs for managing pain and nausea caused by chemotherapy or radiation therapy; and certain cosmetic procedures like veneers. These could include a variety of different procedures that aren’t covered by basic commercial insurance and whose costs aren’t typically covered by insurance policies. Depending on the specific insurance you choose, you may be able to obtain reimbursement of up to 100% of out-of-pocket expenses. Another benefit is that when an event happens unexpectedly, you’ll be able to claim reimbursement for out-of-pocket expenses from your health insurer up to 100% of the cost of the procedure or medication, whichever comes first.
includes things like vision, hearing aids, and eyeglasses; prescription drugs for managing pain and nausea caused by chemotherapy or radiation therapy; and certain cosmetic procedures like veneers. These could include a variety of different procedures that aren’t covered by basic commercial insurance and whose costs aren’t typically covered by insurance policies. Depending on the specific insurance you choose, you may be able to obtain reimbursement of up to 100% of out-of-pocket expenses. Another benefit is that when an event happens unexpectedly, you’ll be able to claim reimbursement for out-of-pocket expenses from your health insurer up to 100% of the cost of the procedure or medication, whichever comes first. Comprehensive insurance includes things like hospital stays and doctor’s appointments, pharmacy prescriptions, emergency room treatments, physical therapy services, diagnostic imaging exams, x-rays, lab tests, x-ray machines, ambulance services, dental implants, and home repairs. Again, most companies would not provide a comprehensive policy but may include minor add-ons. It depends on your company’s standards and your location.
Includes things like hospital stays and doctor’s appointments, pharmacy prescriptions, emergency room treatments, pharmacy prescriptions, emergency room treatments, physical therapy services, diagnostic imaging exams, x-rays, lab tests, x-ray machines, ambulance services, dental implants, and home repairs. Again, most companies would not provide a comprehensive policy but may include minor add-ons. It depends on your company’s standards and your location. Life insurance is similar to health insurance but in the sense that it provides money to support your loved ones if they need financial assistance with life-altering events such as death, disability, sickness, unemployment, unpaid bills, etc. It is possible to obtain both life and health insurance policies, so there is really no reason to limit yourself to just one type that would best serve your needs. People who are looking to buy either type of coverage are often advised to speak with an insurance agent who can provide guidance on choosing the best coverage as a member of a larger group, as an employee, or as a retiree.
An important thing to remember about insurance coverage is that every insurance provider has a different focus and approach, and there is no standard answer to why coverage exists. Each company works diligently to develop customized plans to meet the needs of its own employees. Be aware of the limitations of most of these plans and learn how exactly you would like to be covered. Many providers will include non-medical items that are covered by workers’ compensation. These would include wages and benefits. Other providers may exclude certain medical or surgical treatments, making protection impossible.
Dentists vs. General Dentists
When speaking with a potential provider you should ask them about their relationship with the government organizations that provide access to coverage in your area. All providers will have relationships with at least three different government agencies: 1) Medicaid — the Department of Health and Human Services; 2) Medicare; 3) Children’s Health Insurance Program (CHIP). They must all provide coverage under a federal program, meaning the state may not participate as long as the company is headquartered in a state that participates. Otherwise, your provider will have no objection if it wants to sell coverage to you.
Dentist offices will be more familiar with local governmental programs, including Medicaid for children, Medicare to seniors 65 years and over, and CHIP for kids ages 6-17 (or those in foster care.) Those who specialize in treating the elderly and those at high risk for conditions like diabetes, hypertension, etc., are less familiar with Medicaid and other forms of public assistance programs. Ask the office if they need to discuss this with you and about their interaction with Medicaid coverage. The same goes for general practitioners. Discussing with your dentist whether they would be willing to assist you in obtaining supplemental coverage may be helpful to determine if other insurance and/or medical plans are acceptable. Keep in mind that generally, doctors will be happy to refer your insurance or personal health care plan to a colleague, but you should confirm that prior to accepting service from an independent specialist. Don’t forget to mention that you may also want to request the approval to enroll in another health care plan, particularly if you’re worried about losing coverage after retiring. Additionally, it helps to get written recommendations for insurance from previous patients before signing.
Your insurance company does not operate in a vacuum. It interacts closely and effectively with other healthcare providers throughout the country. Not only does it recommend any new coverage you might be considering at initial diagnosis, it also supports insurers (including hospitals or specialists) by acting as an independent third party. It also takes responsibility for you if you are denied medical coverage due to the refusal or delay of care by other insurers. Therefore, you need to discuss questions about the advantages and disadvantages of obtaining dental insurance policies with your current or prospective providers. Ask for a referral to a qualified insurance company to help resolve any issues you may face regarding insurance coverage.