ML Christensen DDS and Associates accepts payment from most dental insurance or third-party dental payment plans. Plans which do not list the office as a “preferred provider” or “contract dentist” usually still pay benefits for treatment received at ML Christensen DDS and Associates, though the co-pay or patient portion of the cost may be a little different than at the office of a ‘listed’ provider. Plans for which the office currently is listed as a participating provider include:
- PEHP (Public Employees Health Plan)
- BCBS (Blue Cross Blue Shield)
- DMBA (Deseret Mutual Benefit Administrators)
- United Concordia
- Dental Select – Signature Plan only
Dental benefit plans often entail a deductible, patient co-payment, initial waiting period, annual payout limit, and various exclusions that sometimes include the very treatment a patient is seeking, like implant-related or cosmetic treatment. Rather than providing “insurance” to hedge against a catastrophic event, these plans function more like a pre-paid dental benefit plans. Caution is urged for individuals not covered by an employer-subsidized group plan who may be considering purchase of an individual plan. Instituting good oral hygiene practices and self-funding a tax-deductible medical expense account may be a wiser solution than purchasing an individual dental benefit plan.
Information on self-funded direct reimbursement dental benefit plans for employers of all sizes can be found on the ADA’s page: How Direct Reimbursement Works
Dental Coverage And The Affordable Care Act
How does dental insurance work under the Affordable Care Act?
Under the new health care law, dental insurance requirements are different for adults than for children.
Dental coverage for children 18 and under is an essential health benefit. This means it must be available as part of a health plan or as a free-standing plan. However, this is not the case for adults. Insurers are not required to provide or offer adult dental coverage.
Starting in 2014, everyone must have health coverage or pay a fee. But this is not true for dental coverage. Not having dental coverage does not impose a penalty.
Dental coverage is available two ways:
- Health Plans that Include Dental Benefits. In the Marketplace, dental coverage will be included in some health plans. When they shop and compare plans, purchasers will be able to see which plans include dental coverage and what the dental benefits are. If a health plan includes dental coverage, the purchaser will pay one premium for everything. The premium shown for the plan includes both health and dental coverage.
- Separate, Stand-alone Dental Benefit Plans. In some cases separate, stand-alone dental benefit plans will be offered. Purchasers may want to consider this option if the health plan they are considering does not include dental coverage, or if they want different dental coverage. Those who choose a separate dental plan will pay a separate, additional premium for the dental plan.
What are “guaranteed” and “estimated” prices for dental plans?
When shopping for separate, stand-alone dental plans in the Health Insurance Marketplace, one should look for the words “guaranteed” or “estimated” next to the listed premium.
“Guaranteed” means the dental plan will charge the premium shown on the website.
“Estimated” means the dental plan could cost more than the price shown. Purchases could be charged more based on their dental history, gender, line of work or other factors.
A lower “estimated” premium may look less expensive than a higher “guaranteed” premium, but it may be more expensive in the end.
However, purchasers of an “estimated” premium plan will learn from the dental insurance company what the actual premium will be before they pay their first premium.