Whenever we experience dental pain or discomfort, we cringe because of two things – the ache itself and the thought of the expensive appointment with a dentist. We sometimes forego seeing the dentist just because we know their services are just too costly. But now there is this thing called a no gap dental policy your health insurance offers. What is it and how does it make your dental problem easier on the budget?
No gap dental: What is a gap?
A gap is the difference between the specific amount your insurance company covers and the total cost of the procedure you underwent. For instance, if your dental fillings cost $120 and your health insurance covers $100 for dental fillings, you have to pay for the gap of $20.
No gap dental: What is it?
A no gap dental policy is a specific dental benefit offered by dental health insurance companies where there is no out-of-pocket charge for certain dental procedures under the hands of participating dentists. This policy means that the whole procedure will be considered free and covered by your health insurance.
No gap dental: What procedures get covered?
Different health insurance companies cover different dental procedures and treatments, all leaning towards being preventive to avoid more expensive dental treatments in the future. The following are the most common procedures that are considered preventative in nature.
- Initial consultations
- Teeth scaling and cleaning
- Imaging (x-rays)
- Dental fillings
- Fluoride treatment
- Mouthguards (customised as protection for sports)
- Other preventative check-ups
Dental health insurance companies may cover other dental procedures if they are for the prevention of more serious dental conditions. However, orthodontics and cosmetic dentistry procedures are not covered or included.
No gap dental: Things to consider
Here are some things to remember when thinking of having a dental procedure done and you know you have the no gap dental policy as part of your health insurance coverage.
You have not exceeded your benefit limit. You can only take advantage of the no gap dental policy if you have not reached your health fund limit.
You still have to pay monthly premiums. Yes, the no gap dental policy can cover your preventative dental procedures if you are also paying for the monthly premiums of your health insurance.
The insurance company covers your dental procedure. There is a specific list of dental procedures and treatments that each insurance company covers. Be sure to confirm with your insurer about your chosen procedure before anything else.
Your dentist is a participating dental provider. Different health insurance companies also have different affiliated dentists to perform these procedures. Know if your dentist is covered by your insurance to avail the no gap dental policy fully.
Every no gap dental policy has a benefit limit. The insurer will only pay for your covered dental procedures until you reach this ‘credit’ limit. Know your benefit limit and plan your use so that you can enjoy a convenient and ‘free’ dental experience.