Compare different HMO insurance plans in California. Learn more about dental insurance and plan types from our website. When you learn about the different dental insurance plans and how they work you are able to choose one that will best address your dental care needs.  If you should have any questions about the dental insurance plans we have to offer just call our member service line at 310-534-3444

Dental Insurance – Dentures

There are plenty of dental insurance plans that will cover dentures, but you need to plan ahead. Many but not all dental insurance plans have waiting periods from 6-18 months.

As an example: Replacing teeth with dentures is classified as major dental services. The average benefit is 50% co-insurance for your dentures. Dentures are covered by some dental discounts dental plans. Remember discount dental plans are not insurance dental plan.

What happens when you get dentures?

Full or partial dentures replace your teeth when you have lost your natural teeth, from periodontal disease, tooth decay or injury. They will help your appearance and your health including support for facial muscles sag which makes a person look older. Dentures normally take one month and 4-5 appointments which include the initial exam, wax bite impressions, and final denture adjustments.

Question: Costco sells a Delta Dental plan Delta Care, but you have to be a member of Costco which I am not. I know about it because my friend told me.  Can I get this plan or one like it for myself?

Answer: Yes, our website also offer Delta Care USA HMO plan for individuals to buy directly as well as California Dental and PrimeCare.  All these are HMO plans you can compare and choose which is best for you.

Question: I am looking for dental insurance where I am not paying for my dental services in full to my dentist then having to wait to get my money back from the dental insurance company.   Right now that is how my curent dental insurance works. I am willing to drop that plan although it does pay out well so that I am not having to foot the complete bill just to get my dental services done.  What type of plan will let me do that?

Answer: A dental HMO insurance plan is the type of plan, you may want to review if you want to get dental insurance were you are not filing dental claim, and where you pay the amount shown for dental services within the plan.

Dental HMO are fee based plans, showing you your cost for all the different dental services covered under that plan. This type of plan lets you know what your cost for each service covered. You do not have to file claims because the dentist is charging you based on the fee schedule.

It is always important to read and understand your dental insurance plan limitation and exclusions. Dental insurance plans are designed to help with part of your dental expenses and may not always cover all your dental needs.

The typical dental insurance plan has limitations and exclusions, meaning the plan does not cover every aspect of dental care. This can relate to the type or number of procedures, the number of visits or age limits. These limitations and exclusions are carefully detailed in the plan booklet and warrant your attention. This booklet can help you develop realistic expectations of how your dental insurance plan can work for you.

Incisors: Incisors are the four front teeth in the mouth.  They are located in both the maxillary and mandibular arches.  The two center teeth are known as central incisors and the teeth on either side of them are known as lateral incisors.  All of these teeth are responsible for cutting or biting food.  They act like scissors.

It is a good idea to have your dentist complete and submit a request for a cost estimate, if your dental care will be extensive.  This will allow you to know in advance what procedures are covered, the amount the benefit your dental insurance plan will pay toward treatment and your financial responsibility.

However it is important to understand that a pre-treatment estimate is not a guarantee of payment. When the services are complete and a claim is received for payment, to your dental insurance carrier, they will calculate payment based on your current eligibility, amount remaining in your annual maximum limitation minus any deductible requirements.

Question: I have a dental PPO insurance plan and live in NY. I would like to know how do I know what the plans UCR fees are before having the dental services render because I keep getting hit by additional UCR cost (that I do not always have the money for) that I am unaware of at the time I have the dental service.

Answer: In order to budget dental service under a PPO plan and to avoid UCR or at least know what those charges would be a head of time, you must first have your dentist submit a claim quote only. If your dentist submits a claim as a quote only to your insurance company before starting the dental services, your insurance company will then be able to provide you with the amount they will pay on the services prior to you having the done. This way you will know the dollar amount of what you will be responsible for. Normally this is done for any dental services that exceeds $300.00. Just talk to your dentist and let him/her know this is how you like to have things done in the future.

Many dental insurance plans have a coinsurance provision. A coinsurance means the dental plan pays a predetermined percentage of the cost of your treatment, and you are responsible for paying the balance. What you pay is called the coinsurance, and it is part of your out-of-pocket cost. as an example major services benefits may read as 50% covered so your coinsurance would be the remaining 50%.

Each tooth in the mouth contains four different tissues, each has a different function.  Your teeth are made up of two major parts:  the crown and the root.  The crown of the tooth is what is visible in your mouth.  The root of the tooth is the portion which normally not visible in your mouth and is anchored within the bone.  Within each tooth, the four different tissues that are present are the enamel, the dentin, the pulp and the cementum.

* Enamel: The tooth enamel makes up the protective outer surface of the crown of the tooth.

* Dentin: Dentin makes up the majority of the inner surface of the tooth. It can’t normally be seen except on x-rays.

* Pulp: The pulp is the area inside the tooth that holds the nerves and blood vessels of the tooth. It is in the center of the tooth and is in both the crown and the root of the tooth.

* Cementum: Makes up the outer surface of the root of the tooth, and it is much softer than enamel.

Most PPO’s and Indemnity dental insurance plans have a specific dollar deductible.  The deductible works like your auto insurance. During a benefit period, you personally will have to satisfy a portion of your dental bill before your dental insurance plan will contribute to your cost of dental treatment. Your dental insurance plan information will describe how your deductible works. Dental insurance plans do vary on this point. For example, some dental plans will apply the deductible to diagnostic or preventive treatments, and others will not.

Question: I am on a fixed income and can not afford a dental PPO insurance plan at this time. Therefore I am looking into HMO dental insurance plans. However, since I am new to having to pick a plan provider is there any advise you can provide so I choose a good dentist.

Answer: When having to choose a dentist in a network provide plan like a dental HMO her are a few tips you may want to keep in mind.

1) Call the providers listed and confirm they are still accepting the plan and new members.

2) Confirm anything that is important to you but keep it simple. Such as hours of operation, how far booked up are they, do they do the type of dental services you are looking for. You may want to ask if they have their own website so you can review detail information about their practice.  However avoid questions such as “how much is it to fix my broken tooth” They are not going to know that type of question without first seeing you and examining your tooth.

3) I suggest making sure the plan you are reviewing has more then just one dental office as a provider in your area(or how ever far you are willing to travel).  You want a dental HMO plan that has at least three or more dental offices so if you what to change dental office you will be able to do so.

4) If you want to know more about the dental office in question try reviewing online review sites such as Yelp or Angie’s list

HMO insurance plans are normally the more affordable and budget friendly dental insurance option. However they only really work if there is a dentist in their network you want to go to. So taking the time to talk to and review the dental providers in the plan network of providers is worth doing. The more you like your dentist the more likely you will be to maintain your dental health care.

When shopping for dental insurance may notice that most PPO and Free choice of provider call Indemnity insurance plans will come with an annual dollar maximum. This is the maximum dollar amount a dental insurance plan will pay toward the cost of dental care within a specific benefit period (usually January through December). You will be personally responsible for paying costs above the annual maximum limitation. Therefore make sure you are buying a dental insurance with the highest maximum limitation you feel will best fit your dental care needs.