In dental insurance, it would create an adverse selection situation for an insurer to offer
more than one open enrollment period during the year.
Dental insurers often pay claims on a U____C__ and R______basis, since the cost of
dental care varies by geographic area.
usual, customary and reasonable
The primary difference between usual, reasonable and customary and stated coverage
is that stated coverage does not vary.
Most dental insurance plans do not cover
cosmetic dentistry.
T/F Scheduled health insurance benefits and benefits that are paid on a usual, customary and reasonable
basis are different because scheduled benefits contain a list of covered benefits and the amounts to be
paid for each benefit.
TRUE
Under dental insurance, "prosthodontics" includes
bridgework.
Dental insurance has no deductible on
diagnostic or preventative care.
On an "integrated" medical/dental plan, the deductible may be satisfied by WHAT?
medical or dental expenses
Orthodontics" is the treatment of problems related to the
growth and development of the jaw using
fabricated appliances, most often braces.
Dental insurance often is written to include a
probationary period," which excludes coverage for preexisting conditions for a specified period of time.
Examples of restorative care is?
fillings, inlays and crowns.
Does dental insurance cover restorative care?
yes
Dental insurance covers the treatment of gum problems, which is known as
periodontics.
Dental insurance covers root canals, which is known as
endodontics.
To prevent "adverse selection," most dental insurance is written on a
group basis.
Dental indemnity plans may be written as either
scheduled" (basic) or "non-scheduled"
(comprehensive).
Basic dental insurance plans have what type of coverage?
first-dollar coverage, without a deductible or coinsurance.
Comprehensive dental plans are similar to major medical expense plans,
with a deductible and coinsurance.
Limitations may be placed on the number of what type of visits?
preventative care visits allowed in a 12 mth period
Is there a limit on the number of teeth needing treatment?
NO
Dental insurance may also be written as a
pre-paid service plan in the same manner as an HMO