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Dental Insurance Coverage: Is there any way to get around the waiting periods?

Question: I have a PPO that has a waiting period for almost everything. Since I have the plan for seven months, I only have five more months until I can have significant services. When I bought the plan, I did not think waiting periods would be an issue and that I could wait them out. Now, I need a crown that will cost about $900.00. After the waiting period, the insurance company that I am with will cover 50% of the cost.

I need the crown now; are there better ideas than waiting five more months? My dentist said I should get the crown now since it will help protect my chipped tooth. Can I get the crown and file the claim after the waiting period? That way, I will at least get my $450.00 back in the five months after I file the claim. I hate spending money that my insurance company should pay out for.

Reply: I can understand your frustration with waiting for the insurance company to cover the cost of your crown. It’s good that you have consulted with your dentist and know the importance of getting the crown to protect your chipped tooth. 

Consider asking your dentist if they offer any payment plans or financing options. A payment plan could allow you to get the crown and pay for it over time rather than waiting for your insurance to kick in. 

I would advise against filing the claim after the waiting period. Most insurance companies have policies requiring claims to be filed within a specific time frame, typically within a few months of the service date. 

It’s important to understand that filing a claim for a service received during a waiting period but saying it was after could be considered insurance fraud. If someone files a claim with false information, the insurance company may deny it, revoke the policy, or even pursue legal action.

Suppose an individual receives crown treatment during the waiting period of their insurance policy and submits a claim stating that the treatment was accepted after the waiting period. In such cases, the insurance company considers this act as fraudulent. If the insurance company uncovers this false information, it will reject the claim and inquire into the policyholder’s other claims and medical history. This could result in a considerable hike in insurance premiums or even policy cancellation. Moreover, most dental offices file the claim to the insurance company, and it is doubtful that they would mistakenly mislead the insurance company about the date of service.

In short, honesty is always the best policy for filing insurance claims. It’s essential to follow the insurance company’s rules and regulations and not engage in fraudulent activities. If you have any doubts or questions about your insurance policy, it’s always a good idea to contact your insurance provider for clarification.

Ultimately, the decision is up to you. It may be worth weighing the pros and cons of waiting for insurance coverage versus paying for the crown out of pocket and considering any payment options that may be available to you.

Consider a Temporary Crown for Your Chipped Tooth: Benefits, Insurance Coverage, and Advice from Dentist

You could discuss with your dentist the possibility of getting a temporary crown until your waiting period is over. Temporary crowns are acrylic and designed to protect your chipped tooth, maintain your bite, and prevent further damage until the permanent crown is ready.

Temporary crowns are typically much less expensive than permanent crowns, which could make them a more affordable choice for you. Some dental insurance policies cover the cost of temporary crowns, even during the waiting period before placing a permanent crown. It’s always a good idea to check with your dental insurance company’s member service to verify if they cover temporary crowns. If they do, it can help you make an informed decision about your dental care and save you money. Feel free to ask your dentist about the pros and cons of temporary versus permanent crowns and which option might suit your situation.

However, it’s essential to remember that temporary crowns are less durable and long-lasting than permanent crowns and will eventually need to be replaced. Your dentist can advise you on whether a temporary crown is the best option for your situation and help you make an informed decision.  

Getting a Dental HMO Insurance Plan

An alternative solution to consider when needing a crown during a waiting period is to purchase a dental HMO insurance plan that does not have waiting periods. This option can help reduce the crown cost if you have yet to start any work on the tooth that needs the crown. 

However, it’s important to note that this may require you to change to a different dental office that accepts the HMO plan. Fortunately, many dental offices accept HMO plans, so finding a new provider that meets your needs should not be difficult. Be sure to consult with your dentist and insurance provider to discuss this option and determine whether it is the right choice.

Dental Discount Plan May Help You Save Money During a Waiting Period

Dental discount plans are an alternative option that can help you save money on dental services, including crowns, during a waiting period. These plans are not insurance policies but membership-based programs offering discounted rates for dental services. 

Dental discount plans typically have no waiting periods and can be used immediately. You can enroll in a dental discount plan and access discounted dental services, including crowns, immediately, even if your current dental insurance plan has a waiting period.

One of the benefits of dental discount plans is that they often offer significant discounts on dental services. The discounts can vary depending on the plan and the provider, but they can range from 10% to 60% off the regular cost of dental services. 

Another advantage of dental discount plans is that they are generally easy to use. Once you sign up for the plan, you can present your membership card at the dental office to receive the discounted rate. No claim forms or waiting periods; you can use the plan as often as needed.

It’s important to note that dental discount plans are not insurance policies, so they do not cover the entire cost of dental services. Instead, they offer discounted rates to help you save money on dental care. Dental discount plans may be a good option for people who do not have dental insurance or who have a waiting period on their current dental insurance plan.

Cash Discount May be an Option 

If you choose to get the dental crown during the waiting period, it’s worth discussing with your dentist whether they offer a cash discount for services not filed with insurance. Some dental offices may provide a discount for patients who pay in cash, saving them the time and cost of filing an insurance claim. It’s always a good idea to ask your dentist about any discounts or payment options.

Additionally, a cash discount could help you save money in the long run, especially if you don’t plan on using your insurance for any other dental procedures during the waiting period. However, it’s essential to remember that not all dental offices offer a cash discount, and the discount amount can vary. 

Therefore, it’s essential to discuss the cost of the crown with your dentist and any payment options available. Being transparent with your dentist about your financial situation can help them better understand your needs and find ways to work with you to provide the best possible care.

Finding Affordable Dental Insurance Plans with Dental4Less.com

In conclusion, waiting for insurance coverage for necessary dental procedures can be frustrating, but it’s essential to avoid committing insurance fraud. Filing a claim with false information can lead to severe consequences, including policy cancellation, legal action, and a considerable hike in insurance premiums. Therefore, it’s crucial to consider alternative options when needing immediate dental care, such as payment plans, temporary crowns, or purchasing a dental HMO plan without waiting periods.

Dental4Less.com offers a wide range of dental plan types that can assist you in finding an affordable and reliable dental insurance plan that meets your specific needs. Our team of experts is available during business hours of M-F 8-4, and we’re always happy to help. We understand that dental care can be expensive, and we aim to provide options that make it more affordable while ensuring you receive the care you need.

We believe honesty is always the best policy when filing insurance claims. Therefore, we encourage you to avoid fraudulent activities and follow your insurance company’s rules and regulations. If you have any questions or doubts about your policy, please don’t hesitate to contact your insurance provider for clarification.

In summary, exploring alternative options and finding a dental insurance plan that meets your needs is a better and more honest approach than filing a claim with false information. Dental4Less.com can help you find affordable and reliable dental insurance plans that fit your budget and dental care needs. Contact us today at 310-534-3444 during our business hours of M-F 8-4, and let us assist you in finding the right plan for you.

Dental 4 Less – Insurance and Thinking Ahead

You should think ahead when getting dental insurance.

It may seem surprising that many people do not have dental insurance. However, dental insurance benefits are only sometimes offered through work, so people do without until a significant dental need arises. The problem with waiting until you need dental insurance is that it can be too late to get the type of dental insurance you want. You may need a dental PPO plan to stay with your dentist.

However, most dental PPO plans have long-term waiting periods, so you may not get the coverage you seek when not bought early. If you have a dentist you do not wish to change, find out what dental plans you would need to stay with their dental office. If you are with a dental office that only accepts PPO dental plans, you should consider getting a PPO plan now to have a plan in place for your future dental needs, whether for preventive dental care or major dental care.

Dental 4 Less – Gum Health

California Oral health care, Red and sore gums

I recently noticed that my gums have been hurting slightly and seem redder than usual. I brush twice a day and floss almost every day. They do not bleed when I am doing that but they just kind of hurt when I do. Could I have gum disease?

Reply: Some of the start signs of gingivitis (gum disease) would include but are not limited to, Swollen or puffy gums, Dusky red or dark red gums, and tender gums. I suggest visiting your dentist as soon as possible, so if you have the start of gingivitis, your dentist can treat it before it becomes a more significant issue. Consider buying dental insurance if you do not have any current, as it will help to keep your dental care cost more affordable.

Posted on Mar. 26th 2024, by Gina, in Dental Care, Dental help, Dental Oral Health, Gingivitis, Gum Pain, No Comments »

Dental 4 Less – Dental Insurance Facts

Are You Getting the Facts Before You Buy Dental Insurance?

When shopping for dental insurance online or through an agent, know all the facts about each type of dental plan before buying one. Mistakes happen when you need clarification on how a dental plan works. Purchasing dental insurance online is easy and convenient, but people need to read and understand what they buy. Before hitting the submit button, ensure you understand the plan’s terms.

Does the dental plan have waiting periods or yearly max dollar amount limitations? Is the dental insurance plan an in-network dental provider only, or can you go outside the network of dental providers? When is the insurance plan effective? Did you call the dentist to confirm they still accept the dental insurance plan? Is what you are reviewing a dental insurance plan or a dental discount plan? What are your dental needs, and are you getting a dental insurance plan that best fits them?

Taking the extra time to fully understand the dental plan you are buying will save you from headaches and being upset later on.

Dental 4 Less – Dental Discount Plans

I do not have current dental insurance and very little money. My dentist told me I needed dental work on my teeth, so I started looking for dental insurance. Right now, insurance seems too costly for me, but some friends tell me to avoid dental discount plans because they are not insurance. Is this true?

Reply: That is correct. Dental discount plans are not insurance. Dental discount plans help you save money on your dental care cost as long as you go to a dentist who is a provider of the plan. Discount plans are an excellent way to help make dental care more affordable at a low cost. If you want dental insurance, consider reviewing dental HMO plans. Dental HMO plans are the more affordable dental insurance option.

Dental PPO plans let you choose your dentist.

What Dental PPO and Indemnity plans have to offer. Dental PPOs and Indemnity plans allow you to choose your dentist, and for many people, that can be a deciding factor in buying those types of dental insurance plans. For people who want to stay with their current dentist or to be able to choose their dental provider, these types of insurance plans are for that. Dental PPO and Indemnity plans are usually more costly than HMO’s dental insurance plans. Are dental PPOs and Indemnity insurance plans worth the cost? The answer is yes. If you know your dental needs and understand the terms and conditions of the insurance plan, many people are happy with their PPO plans. Trouble comes when you fully understand dental insurance plan’s limitations.

Dental 4 Less – Understanding Dental Insurance.

I need to understand how dental insurance works. I have a dental insurance PPO plan through my job, but it could be better. I am considering removing it and getting just the medical. Why have insurance if you have to pay the dentist?

Reply: Medical insurance has a cost paid out by the insured, too. Dental insurance is designed to make dental care more affordable, not necessarily free. You may not think dental care without insurance is so bad, but to give you an example of how even in preventive care, dental insurance is worth the cost. Say all you need is preventative care.

Without insurance, preventive care costs (Office visits, Bite-wing X-rays, Oral Exam, and Basic Cleaning) can range around $200 – $400, keeping in mind most low-cost HMOs plan range from $8.00 to $20.00 a month with preventive care typical being free. More extensive dental care services become expensive when you don’t have dental insurance.

Dental 4 Less – Individual PPO Insurance

Are Individual PPO Dental Insurance Plans worth buying?

Some people may feel that getting dental insurance is not worth the plan’s cost. That may be true for some dental insurance plans if the person wanting it only wants the dental insurance for short-term use. Many people put off their dental care until they are in pain or have significant dental issues. Then get upset when they find out that many PPOs or Indemnity insurance plans have limitations that will not be able to help them with their major dental care needs immediately. A dental PPO plan is not for those who only want to buy a dental insurance plan to fix a current dental issue and then turn around and cancel the plan once they have their dental work done. The reason is that dental PPOs are designed to be long-term plans and not short-term ones. When considering buying a dental PPO or Indemnity plan, the thing to keep in mind is your long-term dental needs. When getting these types of insurance plans, it is a dental plan you want to keep for at least a few years.

Dental 4 Less- PPO Coverage

PPO Full Coverage Dental insurance for a dental crown

Question:I require two dental crowns. I seek a dental insurance plan covering at least 50 percent or more on a crown and one without waiting periods. Is there a dental insurance plan like that?

Reply: We have two options for you; any of our HMO dental insurance would work. On the HMOs we provide, there are no waiting periods. The crown’s cost typically ranges from $100.00 – $250.00+. Another option would be our Delta Dental PPO plan. That does not have waiting periods; however, the first-year benefits on majors services such as crown run around 10 to 15 percent, and you only have 50 percent benefits on majors services once you have the plan for three years.

Dental 4 Less – Tip on buying Toothpaste

In a prior post we talked about the fluoride content and effectiveness of your toothpaste. In order to get the most from your toothpaste, consider buying  toothpastes that exclude ingredients reduce fluoride bioavailability like SLS. Also buy your toothpaste in smaller containers,and at more frequent intervals so that your toothpaste stays fresh. This simple trick will help your teeth stay strong and is especially important for individuals at a high risk for cavities.

Posted on Apr. 7th 2023, by Gina, in Dental Insurance, No Comments »

Dental 4 Less – Fluoride Bioavailability in Your Toothpaste

The longer your toothpaste sits on the shelf after it is manufactured, the more time there is for fluoride to combine with ingredients in your toothpaste like abrasives, sodium lauryl sulfate (SLS), etc. which reduce the overall fluoride content and effectiveness of your toothpaste. Studies being conducted have shown that this reduction in fluoride availability can occur rapidly over the first few months after toothpaste is manufactured.  This occurs even before your toothpaste reaches its expiration date.

Posted on Apr. 5th 2023, by Gina, in Dental Insurance, No Comments »

Dental 4 Less – Desensitizing Toothpaste Tip

When using desensitizing, do not rinse after brushing for at least 30 minutes. Pro-Argin Sensitive Pro-ReliefThese toothpastes need time to work like they should. By spitting thoroughly instead of rinsing your mouth with water after brushing, you will allow the thin coating of toothpaste remaining on your teeth to get to work providing the relief it is designed give you.

Posted on Apr. 3rd 2023, by Gina, in Dental Insurance, No Comments »

Dental 4 Less – Temporary Dental Insurance for Tennessee.

Question: In another six months I will receive dental benefits though my current employer. Right now I need to have a short term or temporary dental plan that can help me out on a few of my current dental needs. I been trying to put of buying dental insurance since I will be getting dental benefits soon. However one of my teeth are really staring to hurt me. Can you advise if you have any dental plan that I do not have have to keep for a full year or more?

Answer: I would suggest reviewing our dental discount plans as they will help to reduce your overall dental care cost and you can cancel the plan at any time with a 30 days written request to do so. You may also want to review our Dental HMO plan. Although you do pay for the plan annually it is not too costly and may still workout better for you.

Posted on Mar. 31st 2023, by Gina, in Dental Insurance, No Comments »

Dental 4 Less – Affordable Dental Insurance for a Low-Income Mom

Question: I live in Texas and I am a low income mom of two. I do not have any dental benefits only medical right now. I am worry that I can not afford my children’s dental care without some help. Do you offer any low income dental plans?

Answer: Our lower cost dental insurance plans options would be the dental HMO plans we offer on our website when you enter your zip code in the quote box provided. You may also want to review and compare the dental discount plans we provide as well. Both dental plan types are affordable and help to reduce your family dental care cost.

Posted on Mar. 27th 2023, by Gina, in Dental Insurance, No Comments »

What is the process of having braces put on? – Dental 4 Less

I have an overbite and overcrowding. The orthodontists said that I have to get top braces first and then 6 months after I get the bottom braces.  I am getting brace in about three week from now.  I like to know will they hurt a lot. What food will I be able to eat and what food should I not get while I have braces. How will braces feel in my mouth and any suggestion in band colors or colors to stay away from

Posted on Mar. 24th 2023, by Dental, in Individual Dental Insurance Plans, No Comments »

Dry Mouth is a Common Problem Among Seniors – Dental 4 Less

Xerostomia or other wise know as dry mouth is a common problem among older adults. According to the Oral Cancer Foundation an estimates that 20 percent of elderly people suffer from dry mouth.  Dry mouth is also a hidden cause of tooth loss and gum disease in 30 percent of adults.

There are many reasons why you may have dry mouth but for older adults one large factor is that dry mouth can be a side effect to many medications. Medications such as blood pressure, decongestants, antidepressants and pain pill other medications may also cause dry mouth so if you are experiencing dry mouth issue be siree to discuss treatment options with your dentist.

Posted on Mar. 21st 2023, by Dental, in Individual Dental Insurance Plans, No Comments »

Dental Problems Caused by Smoking – Dental 4 Less

Most people know that smoking is bad for your over all health and can cause a multitude of health related problems, however smoking is also a major contributor to many dental problems.   Here are some dental problems that are associated with smoking or using tobacco. Gum disease, receding gums, stained and discolored teeth, tooth loss due to gums disease, bad breath, tartar build up which can lead to tooth decay, and oral cancer.

It hopefully goes without saying that one should quit smoking to avoid oral and dental problem associated with smoking as well as the multitude of health problems.  However, if you are a smoker not quitting they make sure to see your dentist at least twice a year and more if advise by your dentist.

Posted on Mar. 18th 2023, by Gina, in Individual Dental Insurance Plans, No Comments »

Dental 4 Less, Having Dental Phobia Can Cost You Your Oral Health

People with dental phobia are more likely to have active caries (tooth decay) or missing teeth, a new study from King’s College London has confirmed.

The latest study, published in the British Dental Journal, aimed to explore the social and demographic correlates of oral health and oral health related quality of life of people with dental phobia comparted to those without dental phobia. The findings showed that people with dental phobia are more likely to have one or more decayed teeth, and missing teeth as well. In addition, the study showed that those with dental phobias’ reported that their oral health related quality of life is poor.

The results from the study showed that dental phobic people were more likely to have caries (tooth decay) in comparison to non-phobic respondents, and were likely to have one or more missing teeth. The report argued that this could be because many people with dental phobia avoid seeing a dentist on a regular basis to address oral conditions that are preventable and chronic in nature. Once a visit has been made, the phobic patient might also prefer a short term solution instead of a long term care plan, such as extraction.

Posted on Jul. 21st 2017, by Dental, in Individual Dental Insurance Plans, No Comments »

Factors As to Why Your Teeth Can Become Sensitive.  

There are many reason why your teeth can become sensitive.  If you find you have sensitive teeth you should see your dentist.  Having sensitive teeth could be a warning sign to other more serious dental issues. Here are a few reason for tooth sensitivity

* Brushing your teeth too hard. This can wear away the enamel layer.
* Poor oral hygiene. This may allow tartar to build up at the gum line.
* Long-term tooth wear
* Untreated cavities
* An old filling with a crack or leak
* Receding gums that expose the tooth’s roots. Receding gums often are caused by periodontal diseases or by brushing too hard.
* Gum surgery that exposes a tooth’s roots
* Tooth whitening in people who have tooth roots that already are exposed
* Frequently eating acidic foods or drinking acidic liquids

Posted on Jul. 19th 2017, by Dental, in Individual Dental Insurance Plans, No Comments »

Dental 4 Less, Dental Insurance for California Seniors

Seniors can find affordable dental insurance in California on our Dental4Less.com website. Cost of living can be rather high in California, with dental care cost continuing being on the rise it is important to have current dental insurance to help control your dental care costs. Let our member services help you with our dental insurance plans if you have any questions just call 310-534-3444.

Posted on Jun. 11th 2017, by Dental, in Individual Dental Insurance Plans, No Comments »

Finding the Right Senior Dental Insurance Plan For Your Needs.

We at Dental4Less.com can help you find dental coverage that is right for you. Oral health care is an essential factor of senior health and over all wellness. Finding a dental insurance plan that best fits your dental care needs, will help keep your dental care cost more affordable. Studies suggest people with dental insurance are more likely to visit their dentist regularly then those that do not have dental insurance. Regular dental visits is key in maintaining good dental health in seniors.

Posted on Jun. 5th 2017, by Dental, in Individual Dental Insurance Plans, No Comments »

Tooth decay is the leading chronic childhood illness in the US

According to National Institute of Dental and Craniofacial Research, 42% of children aged 2-11 in the US have had dental caries, or tooth decay, in their primary teeth, while 21% of children aged 6-11 have had dental caries in their adult teeth. Poor oral hygiene and high consumption of sugary foods and drinks are common causes of dental caries in children.

Posted on May. 27th 2017, by Dental, in Individual Dental Insurance Plans, No Comments »

Dental 4 Less, Indemnity Dental Insurance

Traditional Fee-for-Service Plan

Indemnity dental insurance is another plan where the plan pays the dentist on a traditional fee-for-service basis.  Indemnity dental insurance is an insurance package where the policyholder can choose his or her own dentist and the insurance provider will be the one to pay that designated dentist your fees or, usually, around half of them.  This indemnity dental insurance plan allows you to select any licensed dentist for service.  An indemnity dental insurance plan is often called a traditional dental coverage plan or a fee for service plan.  You will need to pay a deductible on your indemnity dental insurance.

Posted on Jan. 25th 2017, by Dental, in Dental Insurance, No Comments »

Dental 4 Less, Do a Little Finesse Flossing

Most people know that flossing is a fundamental step in keeping our teeth and gums clean, however this is if you do it right. Snapping and popping your way through the process probably does more damage than good, causing friction on tissue and damage at the gum line. Instead, use about two inches of floss between your fingers, unroll a fresh section of floss for each tooth, and keep the floss tight against your tooth to break up plaque while leaving your gums in good shape.

Posted on Jan. 23rd 2017, by Dental, in Individual Dental Insurance Plans, No Comments »

Dental 4 Less, How to Find the Best Family Dental Insurance Plans

Many of our family dental insurance plans provide access to more than 80,000 providers nationwide and include professional dentists located near your home.  Family dental care doesn’t have to cost an arm and a leg.  Family dental insurance will protect a family’s oral health and insure that trips to the dentist do not painfully affect the your wallet.

Family insurance dental plans are the greatest way to make sure healthy kids with great smiles and a strong mouth and teeth.  Family dental insurances include great benefits and coverage that includes everyone in your family.  Family members For most dental insurance plans are discussed in your household children under 18 years.  Family dental insurance for better oral health is a key aspect that creates a feeling of bond between the family members and is one of the most popular supplemental options for overall medical insurance policies.

Posted on Jan. 21st 2017, by Dental, in Individual Dental Insurance Plans, No Comments »
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