Lincoln Copays, Deductibles, and Coinsurance Definitions
When you are choosing an insurance policy that is best for your family, you will be introduced to concepts like copays, deductibles, and coinsurance. Not only are these important to know when you are trying to compare one plan to another, but you also need to understand how these words affect each plan. They are keywords to determine how much you will pay when using your dental benefits, as well as what your plan covers, depending on the treatment and the circumstance. They unlock the basics of your dental coverage, help you plan for out-of-pocket expenses, and allow you to use your benefits.
Copay
A copay or copayment is a flat fee that you will pay directly to the dentist at the time of service. Copays can vary from one type of treatment to another and can change for in-network providers and out-of-network providers. For example, you may have a $20 copay at the time of service for a routine cleaning or a dental exam. You can expect copays when you have a DMO plan, but you may still have them even if you have a PPO plan. Copays help give you more predictability in your dental costs, so you can plan and prepare for each procedure.
Deductible
A deductible is the amount of money you pay for covered non-preventive dental care before Lincoln Dental Insurance pays. Most plans will cover preventative care regardless of the deductible. Expenses like cleanings, X-rays, and exams usually do not count toward deductibles. For example, if you have a $50 deductible, you would pay the first $50 for basic or major services covered by your plan. Deductibles are typically per person, not per policy, and once the deductible is met, the insurance company pays for services covered.
Coinsurance
Coinsurance is the sharing of costs between you and Lincoln Dental Insurance for a covered dental service. When receiving treatment from an in-network provider who has a negotiated rate with Lincoln, you will share the cost of service after your deductible is met. If your plan covered 80% of the cost of a filling, you would be responsible for the other 20%. Each policy and type of service has different coverage percentages. Coinsurance ensures that you and your insurance company are both invested in your dental health.
Annual Maximums
Lincoln Dental Insurance plans have a maximum amount that they will pay in a given plan year. Insurance plans will only include covered dental expenses when calculating annual maximums. Once the maximum is reached, you will need to wait until the beginning of the next plan year before Lincoln Dental Insurance starts sharing costs of treatments.
Knowing your deductible, coinsurance, and copays can help you tally how much of your annual maximum you have used, and help you avoid unexpected bills.
If you have more questions about Lincoln Dental Insurance or how it could work as a part of your treatment plan to achieve better dental health, reach out to the dentist to see if Lincoln Dental Insurance is the best option for you.
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