Unit 19: Dental Insurance

Question 1

diagnostic and preventative

Answer 1

• routine exams
• x-rays
• regular cleanings
• fluoride treatments

Question 2

restorative

Answer 2

• repairing or restoring teeth that have been damaged, usually by tooth decay
• fillings
• crowns

Question 3

oral surgery

Answer 3

wisdom teeth

Question 4

endodontics

Answer 4

root canal

Question 5

periodontics

Answer 5

gums

Question 6

prosthodontics

Answer 6

bridges

dental implants

Question 7

orthodontics

Answer 7

braces

Question 8

Features of dental insurance

Answer 8

any provider vs PPO
scheduled versus non-scheduled benefits
diagnostic and preventative- usually covered 100%
basic services: fillings, crowns, anesthesia usually 80/20
major services: root canals, oral surgery, gum treatment usually 50/50
predetermination of benefits often required

Question 9

exclusions

Answer 9

cosmetic treatment
replacement of teeth missing before coverage
loss of dentures
occupational injuries

Question 10

group dental

Answer 10

part of a comprehensive policy or a stand-alone supplement
usually a separate policy
may be integrated with medical coverage—one deductible for both

Question 11

adverse selection

Answer 11

probationary periods
limitations on benefits for late enrollees
reduced benefit limits during the first year of coverage