Need Full Dentures, Looking for an Affordable dental plan: I have had some old dentures for over ten years. They are ill-fitting, and the dentist I took them to told me I should get new dentures. As much as I want to get fitted for new dentures, I can not afford them. Are there any dental insurance plans that can help me with the cost of dentures?

Answer: Yes, many dental insurance plans will cover dentures. Since you have had your current dentures for a long time, you should be able to find a plan that will accept you and provide coverage for new dentures. However, there are two things to keep in mind. First, read the plan terms and conditions for dentures to ensure you receive the benefits you seek. Then, be mindful of dental insurance plans with waiting periods. Some plans may cover you for dentures, but the plan itself has waiting periods that are a year or more before they offer benefits for dentures.

Question: I have a terrible toothache and can not take it for much longer. Most dental insurance companies have waiting periods for dental procedures, and I can not continue to wait things out. I need something now, not six or twelve months from now.

Answer: We offer a dental discount plan that may work for you. With our dental discount plans, they start the next business day after signing up for it online through our website. They do not have any waiting periods, so you start saving on your dental care cost immediately. 

We also have HMO dental insurance options. Our HMO dental insurance plan has no waiting periods, but its effective date will depend on when you buy it. For example, if you buy it on or before the 20th of the month, the plan starts the first of the following month. But the plan’s effective date very so read each plan. 

You can call our member service line at 310-534-3444. Our team of experts can explain each plan’s various options and benefits and help you select the one that best fits your needs and budget.

Question: I have a dental PPO plan through Anthem Blue Cross from my employer. Even though I have had it for a few years, this was the first time I used it for more than my free cleaning. About a month ago, I had some dental work that was rather costly. Now, I get an additional billing from my dentist, who stated that the insurance did not pay much for the full porcelain crown I got. However, my dental plan says they will pay half the crown cost. Calling the dental insurance company immediately, I was told that they do not cover that ADA code but will cover up to the UCR rate for covered crowns on noncovered crowns. It seemed like double talk to me. A crown is a crown! What do they mean by ADA code? Help me understand. 

Answer: ADA codes are the service code for each dental service. This code number does not change, and it lets everyone from the dental office, insurance company, and claims department know what dental service you have done. Although wording can vary, the code does not. There are many ADA codes for crowns. Here is a sample.

2740 Crown porcelain ceramic substrate

2783 Crown ¾ porcelain ceramic

2750 Crown-porcelain fused to high noble metal

2751 Crown-porcelain fused to predominantly base metal

2791 Crown-full cast predominantly base and

2810 Crown-3/4 cast metallic

There are more, but I listed a few to show you that a crown is not just a crown. Under many PPO plans may only provide benefits for a lower-cost crown, so when you get a higher-cost crown, they pay out only up to the UCR for the crown they cover. This offers you some savings, but now, it is as much as if you would have chosen a covered crown. One way to avoid billing surprises such as these is to have your dental office submit claims as a quote only to your insurance company before dental services are rendered. That way, you will know your cost ahead of time and can then decide if that is something you wish to continue with based on your budget.

Question: I have four silver fillings that were put in as a kid. Now that I am older and working, I like to change them out for new white filling. Can that be done? 

Answer:  In most cases, yes, if you ask if a dentist changes out the old silver filling to Resin-Based Composite (tooth color filling). However, if you want to know if dental insurance will provide benefits for this type of dental service, often they will not. Many dental insurance plans will not cover this dental service since it is considered cosmetic.

Yet most dental insurance plans will provide benefits when a new cavity in the tooth has the old silver filling requiring the filling to be removed to fix the cavity. In this case, you do not have to replace the filling with a silver filling but can, at that point, replace it with a resin-based composite filling.

Question: I have a dental PPO plan I got through my job. I need help understanding how my dental insurance states my coverages are one thing, but the numbers do not add up when a claim is filed. For example, I had a large filling and a crown not long ago. The filling coverages were to be at 80% paid. Which it was, so that was fine. However, the crown I got cost $1000.00, and my plan said that it paid out 50% of the cost of a crown. Straight forward math right, I should only have to pay $500.00, which was my co-payment of 50%. I then got the billing from the dental office stating the insurance company only paid $450.00, so my cost is $550.00. It is only $50.00 more, but this happens quite often. What should I do about this? 

Answer: In general, PPO plans to pay out a percentage of 80% for essential services such as fillings and 50% for major services such as crowns. But it does not just stop there. Usually, they will state that the percentage paid out is up to UCR (Usual, Customary, and Reasonable). Therefore, if the dentist you are going to is above the UCR rate for the company, you will have an additional charge. Also, some PPO plans will have two sets of coverage, one for network dentists and another for outside-network dentists. Outside-network dentists usually will have fewer benefits than inside-network providers. As to why you are paying more, I could not say which is the case for you. That will be something you should call your plan’s member services for. They can review your benefits and directly answer what is affecting your cost on claims. However, here is a tip you may want to keep in mind. Before starting any dental services, have your dental office submit to your insurance company as a quote only. That way, you will know the actual cost of dental care without worrying about additional expenses.

Question: I am 52 and have been fighting for years to keep my teeth. After years of having major dental services dealing with dental pain all the time and not counting the expense, I am tired of it all. I am considering pulling the teeth I have left and getting complete dentures. The dentist I am going to now does not want to pull my teeth, saying they do not need to be pulled and I should continue having dental care for them. Sure, once they’re pulled and I get dentures, there will be no more dental bills. I am looking for a dental insurance plan to let me have dentures if that is what I want and not say it is elective and not cover them. Please advise. 

Answer: I suggest reviewing dental discount plans. You would want the flexibility that a dental discount plan gives you. With a dental discount plan, your dental services will be up to you and the dentist within the plan. The company does not state what you can or can not have done. 

You get discounted savings for all your dental needs when the services are rendered. If you want dentures, you pay only the discounted cost for them as listed on the fee schedule. You would need to find a dentist in the plan willing to pull out teeth that may not have to be pulled. So make phone calls and ensure you have a dentist in the plan to work with you and your needs.

Also, here is something to think about. Even if you have complete dentures, you must see a dentist regularly for check-ups to ensure that your gums and mouth are healthy. Dentists can also evaluate the fit and function of your dentures and make any necessary adjustments. Additionally, regular dental check-ups can help detect potential oral health issues before they become more serious problems.

Your family oral health care is essential to maintain as your oral health has direct links to your overall health wellness. Therefore, a few ways to keep your and your family’s oral health are good at-home oral health care habits and seeing your dentist regularly. Studies also show that families that have dental insurance in place are more likely to see their family dentist regularly. In addition, dental insurance helps keep your family’s dental care costs lower and more affordable.

Regarding dental insurance for healthy families, it’s important to look for preventive care plans, such as regular cleanings, x-rays, and check-ups. Additionally, plans that cover orthodontia and basic and major restorative services can be beneficial for families with children who may need braces or other dental work. 

It’s also important to consider the network of providers available under a plan and any waiting periods or deductibles that may apply. By carefully evaluating the options and choosing a plan that meets your family’s needs, you can ensure everyone has access to the dental care they need to maintain good oral health.

You can call our member service line at 310-534-3444. Our team of experts can explain each plan’s various options and benefits and help you select the one that best fits your needs and budget.

It is essential to understand that your dental health starts at home.

Maintaining good oral hygiene is essential for having healthy teeth and gums. Here are some tips to help you achieve and maintain healthy teeth and gums:

1.  Brush your teeth twice a day: Brush your teeth at least twice a day with fluoride toothpaste to remove plaque and prevent cavities.
2. Floss daily: Flossing helps remove food particles and plaque between your teeth and the gum line.
3. Mouthwash: Use an antiseptic mouthwash to kill bacteria and freshen your breath.
4. Limit sugary and acidic foods: Sugary and acidic foods can erode tooth enamel and cause cavities. Limit your intake of these foods and drinks.
5.  Drink water: Drinking water after meals helps wash away food debris and prevent dry mouth, which can lead to bad breath and tooth decay.
6. Visit your dentist regularly: Regular dental checkups and cleanings are essential for maintaining healthy teeth and gums. Your dentist can detect and treat any dental problems early on.

By following these tips, you can have healthy teeth and gums and maintain good oral hygiene.

When shopping for dental insurance, the best advice is to read each plan’s terms and conditions carefully. The terms and conditions will let you know what is limited or not covered under the plan. Reading each plan is critical to understanding how it works and whether it best fits your dental care needs.

When reviewing dental insurance plans, it’s essential to consider the plan’s cost and what it covers. Some plans may have lower premiums but may not cover specific procedures or may have high deductibles. On the other hand, more expensive plans may offer more comprehensive coverage. It’s essential to weigh the costs and benefits of each plan to find the one that best fits your budget and dental care needs.

Another tip to remember is to check if the plan has a network of preferred providers. If you have a dentist you prefer to visit, it’s essential to ensure they are included in the plan’s network. Going out of network may result in higher out-of-pocket costs.

Lastly, remember to consider the waiting period for specific procedures. Some plans may have a waiting period before particular procedures are covered, so it’s essential to be aware of this when choosing a plan.

Remember, reviewing and comparing dental insurance plans can save money and ensure you receive the dental care you need.

Also, remember our member services are here to help you if you have any questions about the different dental insurance and plan types we have to offer. It is better to call us at 310-534-3444 if you have questions than to buy a plan that may not work out best for your dental health needs.

Early Childhood Cavities Prevention: Early Childhood Cavities, which includes Baby Bottle Tooth Decay, is an infectious disease that can be prevented. By ages 12 to 19, 23% of children from low-income families have untreated cavities in their permanent teeth, twice that of children from higher-income households.

Early Childhood Cavities Prevention (ECCP) is a nationwide campaign to increase awareness about the importance of preventive oral health care in infants’ first years.

Baby Bottle Tooth Decay: Preventing dental disease is never too early. Primary (baby) teeth are important because they act as placeholders for permanent teeth and aid in proper speech development, nutrition, and self-esteem. Cavities can occur in children less than a year old.

What is BBTD: BBTD, or Baby Bottle Tooth Decay, is a dental condition that can occur in young children when their teeth are consistently exposed to sugary drinks, such as milk or juice, especially at bedtime. The sugars in these drinks can cause decay and cavities in young children’s teeth, leading to pain, infection, and the need for dental work to repair the damage. It is important to avoid giving sugary drinks to young children at bedtime and encourage them to drink water instead. Additionally, it is important to establish good dental hygiene habits early on, such as brushing and flossing regularly and scheduling regular check-ups with a dentist.