Question 1

Should I pay for a dental insurance plan?

Accepted Answer

Dental insurance keeps you healthy and protects your wallet.

Dental insurance typically covers preventive cleanings and exams 100%. This gets you into the dentist to maintain complete oral health while helping prevent costly issues to your gums and teeth. And if you’re in need of a pricey procedure or service, dental insurance lowers your out-of-pocket cost.

Question 2

What are the top factors to consider when choosing a dental insurance plan?

Accepted Answer

Preventive, Basic and Major

There are 3 main categories your service or procedure from the dentist will fall under with dental insurance: Preventive, Basic & Major.

• Preventive: Exams, cleanings, sealants and fluoride treatments. 
• Basic: Fillings, gum treatments
• Major: Implants, bridges, dentures, crowns, root canals and extractions

Some services may be found in either basic or major. It’s important to check for the specific service you’re looking for in the insurance plan you choose.

Coinsurance
Coinsurance is the split cost of what the plan pays and what you pay.
From the main categories listed above (preventive, basic & major), we can look at an example for how coinsurance works.

Example: 100/50/25 (Preventive/Basic/Major)

From this, you would see that your preventive cleanings would be covered 100%, a filling would get 50% coverage and a root canal would get 25% coverage. For the root canal, the carrier pays 25% of the cost, and you pay 75%.

Some plans have graduating coinsurance that increase from year 1 to year 2 and so on up to a certain point.

Also, it’s important to note, insurance will only cover costs up to the annual max limit (see below).

Annual maximum
The annual maximum is the amount of money the insurance carrier will pay out in claims each year. This money does not roll over.

In-Network Provider
An in-network provider is a dentist that has accepted a contractual agreement to lower costs per procedure. This is great for the consumer, because visiting an in-network provider brings savings on procedures which can average 20-50%.

Dentists can opt in or out each year, so it’s important you know if your dentist stays or leaves your network to continue receiving these additional savings.

Question 3

Is there a "best" dental insurance plan?

Accepted Answer

There is no one-size-fits-all dental insurance plan. The “best” dental insurance plan depends on your needs and your situation.

When you think “best” dental insurance plan, you may think: 
• Best for families
• Best for seniors
• Best for no waiting periods
• Best for orthodontics
• Best for annual maximum

With the Direct Benefits Marketplace, we offer a variety of plans to meet these needs. 
We have plans with no waiting periods to get you into the dentist ASAP. We have plans specific to families looking for child orthodontia. For seniors, we have plans with high annual maximums for dentures or implant coverage. With dental insurance, purchase what you need and keep that smile protected!

Question 4

What is the difference between Individual, Family and Senior dental insurance plans?

Accepted Answer

Individual dental plans cover only one person and offer a variety of plans to choose from. A family dental plan covers multiple members of the same family and can focus on child orthodontia and fillings for the kids. And senior dental plans (although not called “senior” plans) offer coverage for services when teeth begin to fade, and the need for major coverage for implants or dentures becomes apparent.

Question 5

What is a dental discount plan, and how does it differ from a dental insurance plan?

Accepted Answer

Discount plans work like a coupon. You show up to an in-network dentist with your discount plan, and you’ll receive a discounted rate set by the dentist per procedure.

Dental discount plans are not insurance but can be a great option in reducing your out-of-pocket costs for your situation.

Question 6

Do your dental plans carry pre-existing conditions limitations?

Accepted Answer

The most frequent situation that arises with dental care and pre-existing conditions is the missing tooth clause.

The missing tooth clause is very common in the dental insurance industry. If a tooth is already missing, there is nothing to insure. Therefore, insurance will not cover the prosthetic (implant) if there is no tooth existing. If your tooth is still intact, then you may be eligible for coverage.

Still, there are some plans available in certain states with limitations around coverage. For more information to see what options may exist, we have a team of experts ready to answer your questions: (888) 890-1944.

Question 7

Can Direct Benefits help me find a dentist near me?

Accepted Answer

Yes. We are here for you with any questions you have before or after you choose a dental insurance plan with us! We’ll also help you determine if you have an in-network dentist close by.

Question 8

Can I have two insurance plans?

Accepted Answer

If you would like to, you can purchase two dental insurance plans. This is called “dual coverage." However, you cannot typically purchase two plans from the same carrier.

You will need to call your insurance carrier to check if the company coordinates benefits to determine if this is the right option for you.

Question 9

Can I bundle vision with dental?

Accepted Answer

Some of our plans offer vision riders as low as $7 a month. Add this to specific dental plans to bundle coverage!

Question 10

Does Medicare cover dental coverage?

Accepted Answer

Some Medicare Advantage plans may offer dental benefits but not as much as other insurance plans you’ll find in the individual market.

Question 11

When is open enrollment for individual dental insurance plans?

Accepted Answer

You can buy dental coverage any time.

Question 12

Why should I pay for a vision insurance plan?

Accepted Answer

Vision insurance helps keep your eyes healthy and cuts down on costs. You’ll save on regular maintenance (eye exams, glasses and contacts), as well as costs covering the diagnosis of eye disease.

Visiting an optometrist will keep your vision on track and will also help prevent compounding issues by catching them early. Vision insurance also provides an allowance and a discount for glasses or contacts each year. Some plans also include prescription sunglasses!

Question 13

What are the top factors to consider when selecting a vision insurance plan?

Accepted Answer

Network savings
Visiting an optometrist in-network will save you money as optometrists have signed contractual agreements to lower the costs per service.

Copay
Vision insurance plans may charge a copay per service, procedure, purchasing of frame or enhancements you receive.

Family 
Instead of paying out-of-pocket for everyone in your family, vision insurance allows you to save money for everyone.

Question 14

Can I combine vision insurance with my other insurance plans?

Accepted Answer

Yes, some of our dental plans offered also have a vision rider add-on for as low as $7 a month. You can also purchase separate dental and vision plans using the Marketplace to ensure coverage that best suits your unique needs.

Question 15

Does eye insurance cover lasik surgery?

Accepted Answer

Yes, some insurance plans do offer discounts on Lasik surgery when seeing a network provider.

Question 16

Can I have two vision insurance plans?

Accepted Answer

Yes. You may already have a vision plan with another carrier.

Question 17

Does Medicare cover vision insurance plans?

Accepted Answer

Medicare plans offer limited coverage for vision insurance. There are restrictions put in place for certain vision screenings and exams. They are not as robust as vision insurance options you’ll find on the individual market.

Question 18

Will vision insurance cover cataracts?

Accepted Answer

No, cataracts falls under medical insurance.

Question 19

When is open enrollment for individual vision insurance plans?

Accepted Answer

You can buy vision coverage any time.

Question 20

Why should I pay for a pet insurance plan?

Accepted Answer

Pet insurance provides peace of mind that your pet will receive the care they need while also helping keep your out-of-pocket costs down.

Question 21

What are the top factors to consider when selecting a pet insurance plan?

Accepted Answer

Your pet’s age, the pet’s breed and where you live will determine pricing. For instance, as your pet gets older, premiums will increase. And certain breeds carry specific genetic conditions that will also affect your final price.

As far as plans go, the lowest level of pet insurance are typically "accident only" plans. As plans get higher in premium (monthly charge), plans cover a variety of conditions and treatments: hereditary conditions, surgeries, prescriptions, rehabilitative therapies and alternative therapies.

Question 22

How does reimbursement work for pet insurance plans?

Accepted Answer

Once you receive a vet bill, you will fill out a claim to submit to your insurance provider. Once that claim is processed, your reimbursement will either be sent to you or deposited directly into your bank account.

The amount of money you receive back will depend on your reimbursement level (70-80-90-100%).

Question 23

Does my pet's age factor into the price of my pet insurance?

Accepted Answer

Yes, as your pet increases in age, the insurance premium is also likely to increase. The exception to this is Accident-only plans, which are a fixed rate regardless of your pet’s age.

Question 24

What are congenital and hereditary conditions with regard to pet insurance plans?

Accepted Answer

Certain congenital and hereditary conditions are approved for pet coverage. It’s important to check your pet policy to ensure your pet’s condition is accepted. Examples could include hip and elbow dysplasia, luxating patella, cherry eye, IVDD, Wobbler Syndrome, glaucoma and epilepsy.

Question 25

What if my pet has pre-existing conditions?

Accepted Answer

Pet insurance does not cover pre-existing conditions.

Any illness or injury that begins before your policy is effective, or during your waiting period, will be considered “pre-existing." Learn more at www.petsbest.com/coverage.

Question 26

What is the benefit cap for pet insurance?

Accepted Answer

Some plans do have an annual limit (amount of money allotted per year) that will run out once you have used it. Other plans have an unlimited annual limit that continues to pay you for services and procedures done.

Question 27

What deductible should I get with my pet insurance plan?

Accepted Answer

Deductibles vary per plan. The deductible you choose is the amount you will be responsible to pay out of pocket before your pet insurance covers the remaining costs. Choose a deductible that works within your budget if something were to happen to your pet.

A deductible is one of many facets of insurance to consider when you weigh all the costs.

Question 28

What veterinarians are in-network with my pet insurance plan?

Accepted Answer

With a Pets Best policy, there are no networks. You can use any licensed veterinarian, including emergency vets and specialists.

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