Metroplus Medicaid and Healthplex Coverage Information for the Bronx

Why Is It Important To Utilise Your Free Mediplus Insurance Benefits?

Dental care is expensive, more so for those who don’t have any insurance. It has been estimated that around 12.8% of people in the US cannot get the dental care they need because of financial barriers. 

Unfortunately, even those who are lucky enough to have dental insurance tend to underutilize their plans. According to the National Association of Dental Plans, about 164.2 Americans have private dental coverage, while another 83.9 million are covered with Government dental plans like Medicaid. Unfortunately, many of these people do not know that their plans offer benefits that can be utilized to get treatment free of cost. Yes, it’s true. But “why would dental insurance companies like Metroplus and healthplex-metroplus offer benefits to their customers” you might wonder. Continue reading to find out the answer to your question. 

Why Do Dental Insurance Companies Offer Benefits?

People who run dental insurance companies are smart. They want to spend as little as possible on the patients while ensuring higher profit margins for their companies. How, they do this? They encourage free treatment benefits like twice-yearly checkup visits, teeth cleanings, and other basic preventive treatments. 

The idea is to encourage the insurance policyholders for plans such as Metoplus-Medicaid to avail free-of-cost dental preventive procedures. That is why they offer you dental benefits - so that you don’t develop dental problems, to begin with - so that all your dental problems are caught in the initial stages - and  the insurance companies like Metroplus-Medicaid, do not have to spend more money on their treatment afterward. 

But this isn’t bad for the patients as well. Instead, this is a win-win situation for both. How? It’s simple: The insurance companies get to save their money - by ensuring optimal health of their patients with minimum spending - while the patients get healthy, pearly white teeth to boast a naturally beautiful smile. 

What Type of Benefits are Offered by Insurance Companies?

The type of benefits available to you depends on two main factors; the insurance company and your insurance plan type. You can read more about different types of dental insurance plans on the American Dental Association website here. 

However, as a general rule, insurance companies offer dental benefits for preventive dental procedures. These include, but are not limited to:

• Twice-yearly dental checkup visits - including advice on tooth-friendly habits and diet
• Professional dental cleanings, once or twice yearly.
• Dental sealants
• Fluoride therapy. 

However, some insurance companies also allow you to utilize your dental benefits for seeking basic treatment procedures like fillings and extraction. You can check with your Metroplus Medicare insurance agent regarding the details of your dental benefits. 

How to Utilize your Dental Benefits?

The process of claiming your dental benefits is simple. Each year, based on your insurance plan premium, your insurance company will set aside certain dental benefits that are valid throughout the year. You can simply ask your dentist that you wish to utilize those benefits -  any time during the year. 

Typically, the insurance benefits Metroplus-Medicaid benefits are renewed in January and expire in December each year. 

What is the Benefit of Using the Insurance Benefits?

Dental benefits are just like income tax returns - but more beneficial. Here are a few benefits of making full use of your insurance benefits every year:

• Enjoy a Healthy and Lasting Smile  - when you visit your dentist twice a year for checkups, naturally, it will be highly unlikely that you will get any problems like teeth cavities or gum problems during that year - and you can enjoy a beautiful and attractive smile. 

• Savings - imagine spending money on procedures that are not covered by your Metroplus Medicare insurance plan, which could have been prevented in the first place through preventive treatment? If you utilize your benefits each year and regularly go for teeth cleanings, you won’t have to worry about periodontal problems or bad breath throughout the next year!

• Healthy Mouth, Healthy Body - when you utilize your Metroplus and healthplex-metropolis benefits, you will not only have good oral health, but it will also have a positive impact on your physical health. This is because your physical health and wellbeing is directly connected with your oral health, says the American Dental Association. The mouth serves as a mirror to your body - whatever you eat goes through the mouth, to other body parts. Naturally, if the mouth is healthy, you can expect a healthy and active body and mind. 

Author

Dr. Guram Yakobashvili, DDS Dr. Yakobashvili is our expert dentist with over 25 years of experience, finished two different dental schools, specializing in emergency dental treatment and cosmetic restorations.