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Understanding Dental Insurance: An Ultimate Guide

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Dental insurance is an important part of ensuring access to the dental care you need to maintain your oral health. But with so many types of dental insurance plans available, understanding dental insurance isn’t always easy.

Understanding Dental Insurance:
An Ultimate Guide By College Family Dentistry

Whether you receive dental insurance through your job, have purchased individual dental insurance or are navigating seeing a dentist without insurance, it’s important to understand how dental insurance works and what your options are.

Keep reading to explore the ins and outs of dental insurance.

Understanding Dental Insurance

How Dental Insurance Works

Most dental insurance plans are designed to cover a portion of the costs for your dental care services.

Dental insurance plans typically cover 100% of preventative and diagnostic procedures, such as regular cleanings and X-rays, and a percentage of other procedures such as cavity fillings, root canals and tooth extractions.

While some dental insurance plans may cover cosmetic procedures such as teeth whitening, teeth straightening and veneers, many plans do not include coverage for these elective procedures.

Some dental offices will have you pay out of pocket at the appointment for any fees not covered by your insurance, while others may send you a bill following your appointment.

Either way, “it’s important to have a good understanding of your dental benefits before arriving at the dentist for an appointment,” said Baton Rouge dentist Dr. Evan Morse. If you’re local, the best way to do this is to call your Baton Rouge dentist office and talk to a treatment coordinator, who can help you navigate what is covered under your dental plan and what your out-of-pocket costs may be.

When working on understanding dental insurance, it’s also important to keep in mind that dental insurance plans are typically annual plans. Most include a “use it or lose it” feature, meaning that if you don’t use your benefits within the calendar year, they won’t carry over into the following year.

If you’re nearing the end of your annual plan and still have unused benefits, be sure to call your dentist and talk with them to identify which benefits need to be used before the end of the year.

“If you need work done we will work hard to get you into the office before benefits expire to maximize your covered,” said Baton Rouge dentist Dr. Morse.

Understanding Dental Insurance: Types of Dental Insurance

The first step toward understanding dental insurance and your specific dental plan, is to explore the types of dental insurance available. There are several primary types of dental insurance plans.

Preferred Provider Organizations (PPO)

A PPO dental insurance plan typically features a network of dentists under contract to the insurance company. Contracted dentists must accept the maximum allowable fee outlined by the plan. With a PPO

plan, you’ll likely look for an “in-network” dentist, but can still see an out-of-network dentist, though out of pocket costs may vary. For example, if you’re in Baton Rouge dental insurance PPO plans will typically cover dentists in your area.

Dental Health Maintenance Organizations (DHMO)

With a DHMO plan, dentists are pre-paid a certain amount each month for each patient assigned to them. Dentists then provide specific services at no-cost or reduced cost to those patients. Because the plan doesn’t reimburse for individual services, patients usually must see an in-network dentist to use their benefits.

Indemnity Plans

This is sometimes referred to as traditional insurance. In this type of dental insurance plan, the insurance company pays claims based on the specific procedures performed, usually covering a percentage of the total fee. Patients are typically able to choose their own dentist.

Direct Reimbursement

With a direct reimbursement dental insurance plan, benefits are based on actual dollars spent, rather than on the type of treatment received. Patients are able to go to the dentist of their choice. A patient typically pays the dentist directly and then submits a receipt to be reimbursed by their insurance company.

Discount or Referral Plans

A company selling a discount dental plan typically contracts with a network of dentists, who agree to discount their dental fees to enrolled patients. Patients pay out of pocket for the discounted rate. While these are often sold to individuals, companies may also purchase discount plans for their employees. Additionally, some dentist offices, like our Baton Rouge dentist office, may have discount dental plans of their own.

Understanding Dental Insurance: Choosing Your Best Option

If you get your dental insurance from your employer, you likely won’t have a choice about the type of dental insurance you receive. But if you’re shopping around for an individual dental insurance plan, or you’re looking for a plan for your employees, it’s important to consider a few key factors when choosing a plan.

  • Costs: Make sure to review the cost for the plan compared to the cash cost of preventative procedures. While dental insurance is a valuable resource, you want it to be worth it.
  • Coverage: Make sure that your dental plan covers at least basic preventive and diagnostic dental care, such as regular cleanings and annual x-rays.
  • Waiting Period: Does the dental plan have a waiting period before benefits take effect? If you need care quickly, seek out dental insurance without a waiting period so you’re covered right away.
  • Pre-Existing Conditions: Much like health insurance, any pre-existing dental conditions you have could impact your coverage or your dental insurance costs. Be sure to look into whether there are any existing dental issues you’re facing that could affect your insurance.

No Dental Insurance? You Still Have Options

It’s great to have dental insurance, but you can still see a dentist without insurance. If you don’t have dental insurance, you typically have a few options.

Pay Out of Pocket

Most dentist offices, including our Baton Rouge dentist office, accept cash, credit cards and checks to cover dental procedures. This is one of the simplest ways to pay for the dentist without insurance, especially if you’re able to afford the costs of your dental treatments.

Purchase Individual Dental Insurance

If you don’t get dental insurance as a benefit through your job, there are plenty of options to purchase personal dental insurance so you’re not faced with a trip to the dentist without insurance at all.

Sign Up for A Discount Dental Plan

A discount dental plan could also be a good option. At College Family Dentistry in Baton Rouge, our Discount Dental Plan includes two healthy hygiene cleanings, two exams and an X-Ray series per member, as well as a periodontal evaluation and intraoral camera exam. Additional services, including cosmetic or restorative dental procedures, emergency visits and Invisalign services, are offered at a discount.

Be sure to read our full guide to seeing a dentist without insurance.

Understanding Dental Insurance: Is Dental Insurance Worth It?

If you’ve generally had good oral health throughout your life, it can be easy to wonder if dental insurance is really worth the cost.

On average, Americans pay about $360 each year, or between $15 or $50 per month for dental insurance. While this amount may exceed the annual cost of a discount dental plan, it is significantly lower than the costs for more intensive dental procedures like fillings, root canals or tooth extractions.

And while simply skipping the dentist if you’re experiencing no obvious dental issues or pain may seem like a fine idea, it can cost you a lot more in the long run – to both your wallet and your health.

Keeping up with regular cleanings, X-rays and other preventative dental care can help spot a potential issue early on, reducing your need for expensive procedures and improving your oral health overall.

If you have any questions about your insurance plan or need more help understanding dental insurance, please contact one of our family of Baton Rouge area dental offices. We’re always happy to help!

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“Ask the Experts” is a series on Baton Rouge Family Fun where local experts share their thoughts, opinions and answer questions relating to health, wellness, parenting and living in Baton Rouge.

 

Hand, Foot, and Mouth Disease

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You know the feeling.  The sign posted on the door of daycare announcing the current illness that is floating around.  Oh the dreaded sign!  “We want to inform you that cases of hand, foot, and mouth disease have been diagnosed here at the center.”  GREAT!  There are likely two questions that are running through your head: 1) So what are we going to do when our child comes down with this latest illness? and 2) What exactly is Hand, Foot and Mouth disease?  Well, that first question is one that I have struggled with many times in my own household, and unfortunately, I can’t help you answer, but that second question…I CAN help with that one!

Hand, Foot, and Mouth Disease

Hand, foot and mouth (HFM) disease is a very common viral illness in children, particularly those under 5 years of age.  Older children, teens and even adults can get Hand, Foot, and Mouth Disease, but it is much less common as most people have had HFM by that time and therefore have natural immunity to these viruses.  This illness is typically seen in the late summer to fall, but especially here in Louisiana with our mild climate, I will see cases of HFM year round.  The virus is spread through contact with droplets of someone who is infected, so it is spread by sneezing and coughing as well as the saliva that children “share” with each other on toys.  It is not uncommon to see mini “epidemics” of HFM that spread through daycare centers or other child care facilities.  The incubation period for HFM is 3-6 days, so I generally tell parents to be on the lookout for signs of HFM for about 1 week after “the sign” is posted at daycare.

What are the symptoms of Hand, Foot, and Mouth Disease

As with any other virus, each child may present differently, but most children will start out with fever.  In the next few days, children will often develop the classic rash that really can be anywhere on the body but, as the name suggests, most commonly is seen on the hands, feet, and around and in the mouth.  The rash looks like small blisters or ant bites, and you will find these spots on the palms and soles of the feet (there are not a lot of illnesses that will cause a rash on the palms and soles but HFM is one of them).

hand, foot, and mouth disease

Especially in infants and toddlers, I will almost always see the rash in the diaper area and on the backs of the thighs as well.  If you look inside the mouth, you may see ulcers on the inside of the lips or tongue as well as in the back of the throat.  These blister lesions will typically continue to pop up over the first 3-5 days of the illness.  After that time the rash will slowly begin to fade, and parents may even notice peeling of the skin where the blisters were located in the coming week.  Finally, some children will have changes to their fingernails or toenails about 4-6 weeks after hand, foot, and mouth disease, and it may appear like the nail is “splitting” horizontally and coming off.  No worries…there is a new nail under there!

hand, foot, and mouth disease

Since HMF is caused by a virus, antibiotics will not make the illness or the rash go away.  The mainstay of care for HFM is making sure children are drinking lots of liquids and using acetaminophen or ibuprofen to help with fever.  Sometimes the throat can be so painful for children that they will not want to drink liquids, and then the concern is that they could be become dehydrated.  When it comes to liquids to offer, I often say that when kiddos are sick, they can have free reign of the liquids…so that means juice, milk, popsicles, Slurpees or even ice cream.  Just something that has liquid form to it!  If your child is refusing to take liquids, make sure and call your pediatrician as there are some occasions where a special mouthwash can be used to help with the pain.  As far as the rash goes, most children are not bothered by the rash.  It doesn’t hurt or itch typically and may only cause mild discomfort when walking for those children that have their little feet covered in blisters.

Now for the last remaining question that every parent asks, “When can my child go back to daycare/school?” and the answer might surprise you.  Once your child is fever free for 24 hours and tolerating liquids well, they can return to school.  Unlike chicken pox, the hand, foot, and mouth disease rash itself is not contagious! The only time I would recommend keeping kids out of daycare in regards to the rash is if they have many open sores that they are itching as these could easily become superinfected with bacteria (this is not very common with HFM whereas with chicken pox, superinfections of the skin are much more common).  The virus that causes hand, foot, and mouth disease can be shed through respiratory droplets for 1 week after the illness and can be shed in the stool for several weeks following symptoms, so by no means are children kept out of daycare or school for this period of time.  This is again one of those times where you hope your daycare is doing a good job of wiping down toys, washing hands, and practicing very good diaper changing hygiene!

For those of you who have been “lucky” enough to experience Hand, Foot, and Mouth Disease already, you may say, “Wait a minute! My daycare told me that she couldn’t return until the blisters were crusted/gone.”  Well, as I said above, fever free for 24 hours is the main criteria for return to daycare or school, but child care facilities are able to set their own return policies when it comes to infectious diseases like hand, foot, and mouth disease, so in many cases, their policy will be the “law of the land.”

So if the next dreaded sign on the door at daycare reads “Hand, foot and mouth disease,” take a deep breath as you are now armed and ready to deal with this unpleasant but all too common illness of childhood.  And as with any illness, if you have specific questions or concerns about your child, please make sure and give your pediatrician a call…it’s what we are here for!

“Ask the Experts” is a series on Baton Rouge Moms where local experts share their thoughts, opinions and answer questions relating to health, wellness, parenting and living in Baton Rouge.

Ask the experts Baton Rouge Moms

Disclaimer: The purpose of this site is to share BRFF’s experiences with food,  fitness, health, and life as well as opinions from some of our local experts. This content is for informational purposes only and isn’t a substitute for professional medical advice.  When it comes to your health or the health of your child, please be sure to contact your physician.

BR Mompreneur – entrepreneurial moms – let’s slay together, y’all!  

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You know when a new no-brainer product hits the market and you say to yourself, “Of course! What a genius idea?”  

That was the exact thought that popped in my head as I sat there at Java Mama. I was in a meeting with the sweetest fellow Momma discussing the great benefits of my small business becoming an ambassador for a brilliant local company.  The problem, I didn’t have the type of money needed.  She threw out some other options and then she said the sentence that set off the light bulb, “Of course, (in these groups) there won’t be child care available!”

How many other entrepreneurial moms out there hear that same thing?

The thing is, I started my business with the main goal of being able to spend more time with my babies.  I wanted the best of both worlds: mommy life and business.  I jumped on the entrepreneur train because I wanted to use my talents in a career, but I also didn’t want to miss out on fields trips and parent lunches. 

BR Mompreneur

As she continued to talk, one thought led to another and then another until I literally heard the lightbulb ding. A local Mompreneur group!  We could support and learn so much from each other.  We could support each other.

I am a huge Lisa Bevere fan. ‘Lioness Arising’ was the first book of hers that I read.  She talks about how the female lions hunt together with their fellow lionesses. They kill together.  They bring the food back to feed their young.  They do it together.

Get this? They do it in a noncompetitive fashion.  They slay together, y’all!  

(Incidentally, they also share mates but I personally think we can pump the breaks and rap up the analogy there.  Boundaries.)

How much stronger would we be for our families, our businesses, and our communities if we came together in support of each other?  We’re raising babies, businesses, and maintaining happy homes. It’s no joke.  I’m actually writing this during nap time with a pile of laundry in view. Raise your hand if you’re with me! 🤚

BR Mompreneur

About me.

I’m Megan Howard Kelly, proud wife and Mommy of two of the sweetest little girls you’ll ever meet.  I am a former reporter/producer at WAFB channel 9, and most recently, alumni of Baton Rouge leadership class (2017-18 – the best class). 

Over the last decade, I’ve run a business and served as Creative Director at Encounter Church.  Currently, I am the owner of MHK Consulting. We’re a branding and marketing company that aims to help you win! Most importantly, I’m founder of BR Mompreneurs.

I’m on the hunt for fellow Mompreneurs in the greater Baton Rouge area to be a part of our new group.  This group’s goal is to connect, equip, and empower.  You can expect weekly posts focusing on personal growth, business education, digital marketing, and networking. I’ll have tips on easy ways you can grow your brand and online reach. You can also look forward to LIVE chats on everything ‘Mom’ and ‘Entrepreneur’. 

Plus, keep your eyes out for Mompreneur meet-ups. I hope you’ll join with me and watch us grow together

West Nile Virus in Baton Rouge: What Parents Need To Know

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If there is a mosquito within a 1 mile radius, it will find me.  I am that person in our family that mosquitos seem to love which my husband finds as a convenient thing for him.  Unfortunately, two of my three children “inherited” this trait from me.  Not only do mosquito bites cause lots of itching and huge red welts if you are like me and my kiddos, but the bite of a mosquito can be the culprit of unwanted illness such as West Nile Virus.  You may have seen recent news headlines here in the Capital City making us aware yet again this year that mosquitos in our area have tested positive for West Nile Virus.  In this two part series, we will discuss what exactly is this virus, what does it mean for your time outside as the summer winds down, and how can you protect your family?

West Nile Virus Baton Rouge

West Nile virus (WNV) is a virus that is transmitted through the bite of an infected Culex mosquito.  The life cycle of the WNV involves mosquitoes feeding on infected birds. The virus then remains in the salivary glands of the mosquito, and when that mosquito “feeds” on humans, WNV can be passed onto the human host.

WNV has been documented across Europe, the Middle East, Africa, and India since the mid-1900s, but it did not make its appearance here in the United States until 1999.  This virus was “imported” to the US by way of New York- most likely by a person who may not have even known they had the virus.  Since 1999, WNV has been detected in every state except Hawaii and Alaska.  We often see outbreaks of WNV during the mid to late summer months of June to September when the Culex mosquito is most common.  In 2016, there were 40 cases of human infection with WNV here in Louisiana.  By comparison, there were 335 cases of WNV in humans in 2012 here in Louisiana.  So far this year, there have been mosquitos that have tested positive for WNV here in Baton Rouge, but from available resources, it does not appear that there have been any confirmed human cases thus far.

Ok so now to what everyone really wants to know…how common is WNV and what should parents be on the lookout for in regards to symptoms?  Great news here- about 80% of people who become infected with WNV will have absolutely no symptoms.  For 20% of people infected, they will most commonly have West Nile fever which is a mild, self-limited illness with symptoms that include fever, body aches, headache, vomiting and/or diarrhea and fatigue.  Approximately 1% of those that are infected with WNV will come down with the serious form of the illness which can include swelling of the brain, known as encephalitis, or inflammation and swelling of the covering of the brain and spinal cord, known as meningitis. Symptoms of neurologic involvement with WNV include high fevers, stiff neck, confusion, muscle weakness, and seizures.  For this 1% of infected people, WNV can be deadly.

There is no specific treatment for WNV.  Since it is a viral infection, antibiotics are not helpful.  For those with the more serious form of WNV, hospitalization might be required in order to provide fluids as well as pain control.  There is lots of ongoing research into possible treatment options for those with encephalitis or meningitis from WNV, but at this time, all of these treatments are considered experimental.  Also, at this time, there is no vaccine to prevent WNV.

Now, we all know that the chance of getting a mosquito bite in the next few months is almost as much of a guarantee as the afternoon rain showers here in the South, so how do you know when to be worried?  No need to panic at the first sign of fever during the summer months as there are lots of other circulating summer viruses other than WNV (In fact, I have been seeing a particularly bad “fever” virus making the rounds in the past few weeks here in Baton Rouge).  Now, if your child ever has a fever along with a drastic change in behavior, weakness or other neurologic changes, immediate medical evaluation is needed (and this is really true anytime of the year and not just during WNV season).

Stay tuned for the second part of this blog series where we will discuss the best ways to protect yourself and your kiddos from the bite of those pesky mosquitos.  

 

“Ask the Experts” is a series on Baton Rouge Moms where local experts share their thoughts, opinions and answer questions relating to health, wellness, parenting and living in Baton Rouge.

Ask the experts Baton Rouge Moms

Disclaimer: The purpose of this site is to share BRM moms’ experiences with food,  fitness, health and life as well as opinions from some of our local experts. This content is for informational purposes only and isn’t a substitute for professional medical advice.  When it comes to your health or the health of your child, please be sure to contact your physician.