Dental Insurance - Fabian Can Help

Discover the Benefits of Dental Insurance

Discover the Benefits of Dental Insurance

Did you know that tooth decay is the second most common disease after a common cold? 

While many wouldn’t consider dental insurance, it has many benefits. You have a head start on your oral and general health with dental insurance. Dental insurance allows you to schedule regular dental checkups with your dentist to detect dental issues early and maintain healthy oral hygiene. When you take a proactive approach, you are more in control of your health and can fix problems before they begin affecting your quality of life.

Understanding Dental Insurance

For people new to the world of insurance, technical jargon can lead to confusion and frustration when selecting the best plan for your life. Young adults trying to navigate the world on their own words, like network, copayment, and premium, can intimidate and steer people in the opposite direction. Below, we have listed a few words to know as you begin your journey:

  • Copayment (often called copay) is a fixed amount you pay for a covered health care service when received (ex., $25 per doctor’s visit).
  • Deductible – the amount you could owe before health insurance kicks in.
  • Network – the health care places and providers your insurer uses to provide you with your care. 
  • Premium – the cost that must be paid for your insurance; this is usually paid monthly, quarterly, or yearly by your and/or your employer.

For a complete list of medical insurance terms, visit here.

But What Does Dental Insurance Cover?

The cost of dental care is much more manageable with dental insurance. Coverage extends to basic needs like preventative services such as check-ups, cleanings, and more. Dental insurance also helps cover the expensive cost of prescriptions and lab tests, depending on your selected plan. Without coverage, these elements can make a significant dent in your wallet; don’t worry, the help of dental insurance is here to help. Let’s take a look at some coverage options: 

  • Dental Health Maintenance Organization (DHMO): This plan has restricted coverage with dentists in their network. However, you will experience lower premiums, shorter waiting periods, and no limit to the annual benefit. 
  • Preferred Provider Organization (PPO): This plan covers visits to outside-of-network providers, which is less expensive than in-network dentists.
  • Indemnity: With the Indemnity plan, you’ll have the most freedom. This plan covers visits with any dental provider (both in-network and out-of-network), but premiums may be higher. 

If you do not have a dental plan, you should explore your options to find the type of coverage you need. Luckily, a local insurance provider will help you every step of the way! When purchasing dental insurance through Fabian Ramirez Insurance Agency, LLC, you can be protected and feel confident in your coverage. Fabian and his insurance experts are ready to help you gain the quality care you deserve.  

In all, you can save money and have peace of mind with individual dental insurance. Now that you have some insight into the insurance world, you can feel better about selecting the health care options that fit your lifestyle the best.

The Truth On Health Insurance

The Truth On Health Insurance 

Unfortunately, getting sick or injured is inevitable. However, with the help of health insurance, you can help defray unexpected medical expenses and ensure protection for yourself and your loved ones. Medical-related expenses can, and will, rack up some pretty hefty bills. For example, one trip to the emergency room can cost you thousands of dollars and leave you financially set back for years. One thing is for certain in this unpredictable world: staying prepared for accidents and illness is imperative.

What Exactly Does Health Insurance Cover?

What some people might not realize is the cost of care does not stop after you leave health care facilities. Luckily neither does health insurance. Coverage extends to basic needs like preventative services (vaccines, screenings, etc.), prescriptions and lab tests as well. These are all elements of health care that can end up costing a pretty penny on their own, especially for single people and those who are single parents. 

Furthermore, services like mental health and substance use disorder services are covered by different health insurance plans. Counseling, psychotherapy and behavioral health treatments all fall under the umbrella of mental health and substance use disorder services and can be covered by your health insurance provider. 

What about your little ones? Insurance offers extended coverage to your family members, children included. Care for new and expecting parents is covered both before and after children are born. It is also important to note that insurance can help offset the costs of other pediatric (and general) needs. Speech-language pathology and occupational therapy are among the most common therapy needs for children all of which are covered under most plans.

    Words to Know

    For people who are new to the world of insurance, technical jargon can lead to confusion and frustration when trying to select the best plan for their lives. This is especially true for young adults who are trying to navigate the world on their own. Words like copayment, deductible and health care savings account can throw people for a loop who are just getting started. Below, we have listed a few words to know as you begin your journey in the health insurance world:

    • Copayment (often referred to as copay) – a fixed amount you pay for a covered health care service when received (ex. $25 per doctor’s visit).
    • Deductible – the amount you could owe before health insurance kicks in.
    • Formulary – a list of the names of prescription drugs your plan covers. 
    • Network – the health care places and providers your insurer uses to provide you with your care. 
    • Premium – the cost that must be paid for your insurance; this is usually paid monthly, quarterly, or yearly by your and/or your employer. 

    For a full list of medical insurance terms visit here.

    Protection You Choose

    Independent healthcare insurance is coverage that is purchased on your own. Obviously, this differs from government or employer-sponsored plans in the sense that you are in control of what and how much coverage you receive. In Texas, more than five million people go uninsured every year; most of whom are probably unsure they can even get insurance without having to go through their employer. 

     

    Private health insurance typically gives purchasers a wider range of options than government-sponsored plans. This means purchasers can tailor their insurance plans to their needs. Plus, the private route will typically lead to shorter wait times and more individualized care if buyers choose to get coverage from local organizations.

    Rest At Ease

    The peace of mind that comes with having health insurance is unmatched. Now that you have some insight into the insurance world, you can feel better about selecting the health care options that fit your lifestyle the best. 

    When you purchase health insurance through Fabian Ramirez Insurance Agency, LLC you can rest assured and be confident in the coverage you choose. Fabian and his team of insurance experts are ready to help you gain quality coverage and promise to be there for you every step of the way.

     

    What’s an EOB?

    What’s an EOB?

    You have insurance, had a doctor’s visit, received an EOB, now what?

    Knowing how to read your EOB or Explanation of Benefits, is helpful to understanding your medical coverage and may keep your gray hairs at bay. Essentially your EOB is a statement from your health insurance plan which breaks down in complete description the costs they will cover for care and or products you’ve received. This explanation is created and delivered once your provider submits a claim regarding the services you’ve received.

    Your EOB Is NOT a Bill

    There’s no need to panic! Your insurance provider sends you an EOB to help make clear:

    • Cost of care you received
    • Amount of money you saved by visiting an in-work provider
    • Out-of-pocket medical expenses you will be responsible for

    How to Read Your EOB

    Please note, EOBs are not bills. They are simply a recorded statement of the medical services you’ve received and details on how your provider plans to share costs. You do not use this to pay an outstanding bill. Your bill can be broken down into a summarization of:

    • Your details and personal information
    • The medical services received and by who
    • Amount billed: The cost of those services
    • Discounts: Money you saved by accessing care from in-network providers
    • Amount covered and paid by your insurance
    • Amount not covered: What costs your health plan didn’t cover
    • Amount that was paid by HRA (if applicable)
    • The outstanding amount you are responsible for paying

    Following this information is usually information regarding instructions on how to make an appeal, and then finally, there are more in-depth details about your total cost of care received.

    The Purpose of an EOB

    When you receive health care, your insurance provider will send you an EOB with the previously stated information. After this is received, you may receive a separate bill for the actual amount you owe. Information on this separate piece of paper will let you know where you can send your payment. Essentially EOBs are helpful because they provide you the value of your health insurance plan and can help you to gauge how much money you potentially have left in accounts related to your health insurance plan. These are also helpful for those who are wondering how close they are to meeting their deductible. That’s all the better because once your deductible is met, your provider will begin to help you pay for services received!

    If you need help understanding this information or feel like you’re in need of a different type of coverage, contact me today at 361-652-3005 and we can get started on providing you with the care and coverage you actually need.

    Should You Buy Dental Insurance? Key Questions to Ask Before You Buy

    3 Questions You Should Ask Before Buying Dental Insurance

    Should You Buy Dental Insurance? Key Questions to Ask Before You Buy

    While dental check-ups are usually needed every 6 months, you never know when a dental emergency might pop up in yours or one of your family member’s mouths that requires immediate attention and a whole lot of cash up front.

    This is when dental insurance comes in handy. Of course, you will probably have to pay a small portion yourself, but with insurance, your provider will usually cover most of the procedure, helping you out financially. 

    If you’re unsure if dental insurance is right for you, we have answered a few important questions to ask yourself before jumping into something unnecessary or overpriced.

    1. Does my employer offer similar coverage?

    First, it is best to talk with your employer about if they offer a dental package. According to Guardian Direct, about 50% of companies offer dental insurance, so there is a good chance that you could save some money by going with them. This makes the most sense because employers actually pay a percentage of the premiums and can negotiate rates with group plans, therefore making you pay less. 

    1. How much are premiums?

    Premiums are how much you are going to spend each month or each quarter, and they vary from provider to provider. They cover anything from dental preventative care, cleanings, root canals, and sometimes more depending on your coverage. 

    If your employer does offer dental insurance, it might be a good idea to continue shopping around, as you might be able to find cheaper insurance privately. Knowing how much you are going to pay monthly or quarterly is important in making sure you aren’t getting in over your head and budget. 

    In addition, an insurance provider that you can go through privately could offer better benefits, making the price difference worth it. Compare benefits from your employer’s dental insurance to the private one you’re looking into to figure out which one is worth what you will end up paying.

    1. Which dentists can I go to?

    Perhaps you’ve already gone to a dentist you liked previously, or maybe you have certain criterias you want a dentist to meet when choosing them as your primary dentist. Either way, it is important to know what dentists are accepted in your dental insurance network that you are looking at getting insurance through. 

    Your provider should have a database where you can look up in-network dentists in your area, or search specifically by the name of the dentist you already know and trust. This also makes it easy for when you aren’t sure who to go to, don’t know which dentists are in-network, and don’t feel like calling around to a dozen places and asking.

    This can also be used when you are referred to another provider for a specific procedure and want to make sure they are in your network.

    How do you buy dental insurance?

    Now the big question is, how to go about getting insurance, for an affordable price and getting the most out of your plan. In today’s world, it is really easy to find an insurance provider by browsing the internet. You can go with the bigger guys, or choose a local agent who can help you navigate the best plan for you and your family and answer all your insurance questions. 

    Still unsure of how to get dental insurance? Fabian Ramirez can help steer you in the right direction and discover what plan is right for you. Call today. (361) 652-3005.