How to Choose the Best FEDVIP Dental Plan
Dental benefits differ widely, and many of the plans" brochures use technical terminology that"s hard to understand – such as "gingival" (gum, in English), "alveolar" (the part of the jawbone that holds teeth in place), and "amalgam restorations" (filling cavities).
Moreover, some plans use schedules of allowances so you don"t know if the full charge will be paid (usually, it"s not). Since the plans limit coverage to the items listed in the schedule of allowances, your problem may not be covered at all, though the schedules are so broad this is a rare problem. Worst of all, no plans offer a catastrophic dental benefit that would cover you if, for example, you developed a chronic jaw infection and required dental procedures costing thousands of dollars more than the plan benefit covers.
If you aren"t sure that a plan adequately accounts for your family"s dental needs, or to be sure you get the network discount, you should talk to your dentist. For example, all dental plans now at least partially cover the cost of dental implants, a very expensive procedure. But exactly which parts are covered, which options are best, which of these parts or options requires plan approval, and how likely your case is to get plan approval, varies from plan to plan. The best way to find out which dental plan will cover your implant at the lowest cost to you is to ask your dentist or dental surgeon what his or her patients" experiences have been.
How much you pay under each plan depends on whether your expenses are mainly for children or adults, and whether for preventive and diagnostic services, or for more expensive restorative services (including surgical, endodontic, prosthodontic, etc.).
Our Guide helps sort this out. First, we provide your cost estimates under each plan. We show the annual premium cost together with the likely out-of-pocket cost under low, average, and high usage scenarios. Because the premium cost is a "for sure" expense, we include it in each column. Our ratings begin with the lowest total cost plan, followed by the remaining plans in order. In most cases, plan-to-plan differences are small, but our presentation lets you compare plans that are likely to minimize your expenses.
We also show the average percentage cost for child preventive, child restorative, adult preventive, and adult restorative services under each plan. These estimates are based on a market basket of common dental procedures. For example, we assume that children receive the following preventive and diagnostic services through an annual visit: periodic examination, prophylaxis, bitewing x-rays, and fluoride treatment. For adult restorative services, our index includes fillings, extractions, crowns, root canal treatment, periodontal treatment, and dentures. Additionally, we provide estimates for some individual procedures. Although the tables show specific percentages, these are rough estimates based on national average prices. Your dentist may charge more or less. We also translate varied plan reimbursement approaches into the "percent you pay," and sometimes this is only an approximation. However, these data can steer you toward plans that include specific benefits.
We also include the maximum benefit levels (if any) that each plan will pay. Most dental plans impose maximum ceilings on what they will pay. If you expect very high expenses, consider a plan with a high or even unlimited maximum, but in most cases you will pay considerably more in premium for this better protection.
All these dental plans have a substantial orthodontic benefit. The coverage terms vary, however, so you should compare them carefully. Especially important, the dental plans often try to discourage you from joining at the last minute to take advantage of these benefits, usually by imposing 12-month waiting periods on eligibility.
The dental plans make the most sense for persons who are sure they will have moderately or very high dental expenses, want protection against an unexpected expense, and like the predictability of paying a regular premium and reducing wide fluctuations from month-to-month in what they may pay.
Before selecting a dental plan, be sure to check with your family dentist as to which plan(s) he or she affiliates with. Our estimates assume that you use network providers. Using out-of-network dentists loses you the network discount and the better cost-sharing. These plans are good buys only when you use network providers. Perhaps the greatest benefit of the new plans for military retirees and dependent families is that you"re no longer forced into a "one size fits all" plan that limits you to its network providers and to its schedule of benefits. You can now choose a plan that serves you well both ways.