Thursday, March 18, 2010

Dental insurance

Dental insurance is voluntary, so you need to actively choose to enroll. You can only do this during open enrollment period each year (usually in November) or within 30 days of when you first start as a post-doc at the university. Exceptions are if you have a life changing event (marriage, birth of child, your spouse lost health insurance etc) then within 30 days of the life-changing eventyou can make changes outside the open enrollment period. If you missed this period or made a mistake and chose the wrong plan, you will need to wait until the next open enrollment to make any changes. We will again continue to have PPO dental insurance just like last year, which means you can pick and choose any doctor whenever you need to see one, as long as they are in-network. However, you have 2 options to choose from within this PPO; high and low options.

Here’s a summary of benefits but as always, you can find more info on the GP website:

At a glance:

High-option costs $48.77 per month per individual ($167.11 for family); $1500 max benefit per person per year

Low-option costs $21.82 per month per individual ($54.55 for family); $5000 max benefit per person per year

There’s quite a bit of a price difference between the two and it’s confusing at first why this is; especially since it seems it should be the other way around when it comes to the premium you pay vs. the benefit you get. From what I understand, high option is the best if you’re planning to use out-of network doctors a lot, since the insurance pays the same if you see an out-of-network doctor or an in-network one. But this freedom comes at another cost, i.e. the max benefit you can claim is much lower in the high option. The only instance that I can think of when this may make sense is if you have a spouse/children in another state and you want to include them in your plan. Otherwise, you’re better off with the low option. Not only you pay less premium, you also get a higher max benefit.

Other than the difference between the premiums and max benefits, both options come with the same basic procedures included in the plan. They include, but are not limited to, 2 routine exams per year, 2 teeth cleanings per year, x-rays etc. So if you’ve paid your premiums all year, you should at least make an appointment to get your teeth cleaning done before the end of December; you’ve earned it. For more complex procedures such as fillings, wisdom teeth removal, root canal etc, both options pay about 80% of the bill for in-network doctors, but you need to first satisfy a $60 deductible if you have the high option before the insurance kicks in. For a list of all included procedures, please check the website.

No comments:

Post a Comment