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Protecting What Matters Most


A Primer on Buying Dental Insurance for Physicians in Texas

Caring for your teeth has benefits beyond a happy smile. Recent studies show a direct link between oral health and overall health.

According to the American Academy of Periodontology (AAP), people with periodontal disease are twice as likely to have coronary artery disease. While exact causal evidence has not yet been provided, the AAP issued a statement to support the American Heart Association (AHA) revelation of an association between periodontal disease and cardiovascular disease.  The American Dental Association recommends focusing on preventative care through regular cleanings, checkups and treatments to maintain oral health.

Keeping your smile healthy is expensive and the costs are only rising. The average cost of a basic cleaning comes in at $127. Add x-rays to the price and you’ll pay estimated extra cost of $198. Need a deep cleaning? That could cost you roughly $1,257. With the high prices of dental procedures, insurance can help maintain oral health and your budget. Below we have outlined important considerations to keep in mind as you shop for a dental plan.

Considerations and Questions to Ask First

Before selecting a dental insurance plan, keep the following considerations in mind to find the best coverage for you and your family.

  1. Inquire about In and Out of Network dentists- Can you go to the dentist of your choosing? What are the policies regarding Out of Network dentists? Get a list of the participating dentists before signing on.
  2. Understand the plan’s coverage- Make sure to ask about coverage for routine and major dental work as well as preventive care.
  3. Review the orthodontia coverage- How much is offered and what are the age limits? This consideration is particularly important for physicians with young children.
  4. Ask about how UCR is used- Ask if your provider uses the Usual Customary and Reasonable fee guide to determine the allowed amount for services.
  5. Request information about the approval process- Request information about requirements for approval and verify the coverage start date.

To get the payoff you’d like, you’ll need to be selective when choosing your dental insurance plan. Ask yourself the following questions as you shop for coverage:

  • Coverage for basic dental work is important but what happens when you need a root canal, your spouse needs a crown and your child needs a filling all in the same year? This is where reviewing and understanding your maximum annual benefit is paramount.
  • What is the amount of the deductible will you have to meet before you are covered? If the deductible is particularly high, you might have to wait longer than you’d like.
  • How much are the negotiated fees for routine and major dental work? Look for plan that allows you to get a pre-treatment estimate right from your dentist’s office. This will allow you to plan ahead and budget for unexpected costs.
  • Are the rates affordable for physicians with families? Looks for rates that do not raise considerably when a spouse or child is added. As orthodontic treatments are typically quite costly, be sure to ask about the coverage provided and age limit for your children.

To learn more about the dental insurance plans available through TMA Insurance Trust, reach out to one of our advisors or find more information on our website

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