Unit 19 Dental Insurance

Question 1

types of treatment

Answer 1

diagnostic and preventive
restorative (fillings, crowns)
oral surgery
endodontics (root canal)
periodontics (gum treatments)
prosthodontics (bridges and dental implants)
orthodontics (braces)

Question 2

features of dental insurance

Answer 2

any provider versus PPO
scheduled versus non scheduled benefits
diagnostic and preventive usually covered 100%
basic services (fillings, crowns, anesthesia) coinsurance is usually 80/20, subject to the annual limit
major services (root canals, oral surgery) coinsurance is usually 50/50 subject to the annual limit
predetermination of benefits is often required

Question 3

common exclusions

Answer 3

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

Question 4

group dental

Answer 4

usually a separate policy
may be integrated with medical coverage, one deductible for both

Question 5

adverse selection

Answer 5

probationary periods
limitations on benefits for late enrollees
reduced benefit limits during the first year of coverage
no conversion privilege