As a dentist, you can have different experiences in dealing with dental insurance. If your office helps coordinate the insurance plans’ coverage for customers, which many dentist offices do, to encourage customers’ loyalty, you may be dealing with multiple insurance providers in that way, as a provider of dental services. You may also have an alternative experience – that of a covered recipient.
Developing a good working relationship with insurance providers, and becoming familiar with insurance plans is a good first step to ensuring your office is coordinating your customer’s benefits properly. Ensuring coordination of benefits rules are properly applied is also essential.
Coordination Of Benefits
Benefits should be applied and sent to the correct dental insurance plan in the order below.
Married Parents with Plans
For a married or person with a common law spouse, where both have a group health and dental insurance plan, the claim should be submitted to the patient’s plan first, as the primary insurance, then the spouse’s, as the secondary insurance. For the spouse, this would be reversed. If you were submitting for this couple’s child, you would submit first to the plan of the parent whose birthday (month and day) falls earlier in the calendar year, before the other parent’s plan.
Divorced Couples
In a joint custody situation, where the exes are remarried or living common-law, the claim should go to the plan of the parent with the first birthday in the year again, then the plan of the second parent. Next would be the plan of the new spouse of the first parent, and finally, the plan of the second spouse.
If sole custody has been granted, and the exes are remarried, submit first to the plan of the parent with sole custody, and then their new spouse. Next, submit to the plan of the second parent, and then their respective new spouse.
Student Coverage
A university student with coverage through a university group health plan and a job, but who may also be considered a dependant will claim first through the student or work plan, whichever was activated first, and then the parents’ plans.
Multiple Work Plans or Retiree Plans
For clients with two jobs, submit to the full-time job, or one with the most hours first. If both are equal, submit to the one the person has been with the longest.
If the client is retired with a retiree plan but is also working and has a plan with that job, submit first to the work plan before the retiree plan.
Coordinating With A Health or Life Insurance Company As A Recipient
As a dentist, you should also make sure you are taken care of, too, as well as your employees. Making sure you have the right health insurance and dental insurance plans is essential.
You need to make sure you have access to the health care and prescription drugs you need to stay healthy and working, without excessive medical expenses. Most dentists are dependent on their dental practice being up and running to pay the bills, so consider this when looking at insurance.
Below are some key insurance areas that dental health professionals need to consider.
Office Insurance
Make sure to protect your practice, as the source of your livelihood. Office overhead insurance can protect you if you are unable to work, so you do not need to worry about business expenses.
Disability Insurance
Another way to help ensure expenses are covered if you are unable to work is through disability insurance coverage. This can replace up to 60% of your income, and if the payments come to you, the proceeds are tax-free. If you don’t make a claim, you may be able to receive a portion of your premiums back.
Health Insurance
Health insurance will help cover the cost of a range of expenses; exact coverage will depend on the specific plan. You can get coverage for prescription drugs, vision care, paramedical services, and more.
Life Insurance
Life insurance offers protection for your loved ones, which is critical but can also aid in tax planning, protecting your families if you have to sell your dental practice, and other major life events. This insurance provides added financial security that many dentists, especially as practice owners, need. There are different options available, including guaranteed life insurance which does not require a medical questionnaire, so anyone can get coverage.
Dental Coverage
You need care for your teeth, too! As you are probably already aware, a basic plan provides essential preventive dental care, including dental exams, tests, x-rays, fillings, and more. Depending on your needs, this may be adequate, but it is worth considering an enhanced dental plan that will ensure no out-of-pocket expenses.
An enhanced plan usually includes orthodontic coverage to allow for more treatment options, and save you money on dental expenses if you need an oral surgery or other critical dental care procedure.
Making sure you have a greater percentage of costs covered, and access to more complete dental care, including restorative dental care and orthodontics helps make sure you receive the dental care you know is so important.
Health and Dental Coverage, Plus More - All Tailored For Dentists
Dental Tax is proud to offer a range of insurance products to our clients, from reputable providers, like the Manufacturers Life Insurance Company. While you are busy providing dental care to customers, we work hard to find comprehensive, affordable dental coverage for you and your employees, so that you can receive the same care that you provide.
We provide both health and dental insurance, to ensure you are covered. We can find you a health insurance group plan to cover prescription drugs, paramedical services, vision care, and more. If you are self-employed, life and disability insurance plans to protect against earnings losses are also important. As necessary, we can find you insurance without a waiting period or required medical questionnaire.
DentalTax offers health and dental plans tailored for dentists, associates, and retired dentists, to give you the coverage you need.
Adam has an MBA from the Richard Ivey School of Business in London and also holds a Chartered Investment Manager designation.
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