Ameritas Copays, Deductibles, and Coinsurance Definitions
When you are reviewing your options for dental insurance coverage, you may feel like you need a manual to understand what the different terminology actually means. Here is your manual to clearly comprehend what your insurance plan will pay and what you will need to cover. Copays, deductibles, and coinsurance dictate the sharing of costs and dictate how much you potentially will have to pay for your care out of pocket.
A copay, or copayment, is a fixed amount of money you pay each time you receive health services. Most Ameritas dental insurance plans have specific copays for different procedures. With copays, you'll know what your share is for the service (cleaning, exam, filling). Copays are predictable because you only pay a specified dollar amount, not a percentage of the total bill.
The deductible is the amount you must pay before the insurance plan starts to cover the costs. Most Ameritas plans pay for your dental cleanings and exams, and do not include preventative care when it comes to the deductible. The deductible will need to be met before the insurance plan starts to contribute to the cost of basic and major services. Deductibles are usually annual, so they reset every 12 months. Once you meet the deductible, the insurance portion of your benefits is available to you for the remainder of your benefit year. Knowing your deductible can help you know how much to budget for necessary procedures and when you should schedule them to maximize your coverage.
After your deductible is met or you have spent a fixed amount on your dental treatment, you will share the cost for dental care with Ameritas dental insurance. The percentage of the costs you and Ameritas each pay is called coinsurance. Rather than paying a set dollar amount per visit, you and Ameritas will each pay a percentage of the treatment cost. Not all plans pay the same percentages for all treatments, so you will need to review your specific plan details. Most often, plans pay a higher percentage for preventive or basic services and a lower percentage for major services. The plan incentivizes preventative care as the cost of regular visits is covered at a higher percentage, allowing you to maintain your oral health.
Copays, deductibles, and coinsurance work together to show how much money you will need to budget for your dental care. You will also need to review any annual maximums and providers that participate with your insurance plan. Your costs may increase if you visit an out-of-network dentist because the out-of-network dentist can set prices without a prearranged agreement.
When you are at the dental office, be sure to talk to the staff about pre-treatment estimates, and then you can review the Ameritas summary documents. You should be able to determine your costs ahead of receiving the treatment.
If you have more questions about Ameritas Dental Insurance or how it could work as a part of your treatment plan to achieve better dental health, make an appointment with the dentist to see if Ameritas Dental Insurance is the best option for you.