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Navigating the World of Dental Insurance Terminology

November 8th, 2018

Unless you work for an insurance company, you probably do not spend a lot of your time studying all the terminology that dental insurance companies use to describe the treatments and services they cover. If it seems pretty confusing, here are some of the most commonly used dental insurance terms and what they mean.

A Basic Glossary

Annual Maximum–The maximum amount your policy will pay per year for care at Bay Smile Docs. It is often divided into costs per individual, and (if you are on a family plan) per family

Co-payment– An amount the patient pays at the time of service before receiving care, and before the insurance pays for any portion of the care

Covered Services– A list of all the treatments, services, and procedures the insurance policy will cover under your contract

Deductible– A dollar amount that you must pay out of pocket each year before the insurance company will pay for any treatments or procedures

Diagnostic/Preventive Services– A category of treatments or procedures that most insurance will cover before the deductible which may include services like preventive appointments with Dr. Clay Gangwisch, Dr. Mike Grandy, Dr. Daniel Melzer, Dr. Andy Holtery, and Dr. John Miller, X-rays, and evaluations

In-Network and Out-of-Network– A list of providers that are part of an insurance company’s “network”

  • If you visit in-network providers, the insurance company will typically cover a larger portion of the cost of the care you receive. If you visit someone who is not part of the network, known as an out-of-network provider, the insurance company may pay for a portion of the care, but you will pay a significantly larger share from your own pocket.

Lifetime Maximum– The maximum amount that an insurance plan will pay toward care for an individual or family (if you have an applicable family plan)

  • This is not a per-year maximum, but rather a maximum that can be paid over the entire life of the patient.

Limitations/Exclusions– A list of all the procedures an insurance policy does not cover

  • Coverage may limit the timing or frequency of a specific treatment or procedure (only covering a certain number within a calendar year), or may exclude some treatments entirely. Knowing the limitations and exclusions of a policy is very important.

Member/Insured/Covered Person/Beneficiary/Enrollee– Someone who is eligible to receive benefits under an insurance plan

Provider– Dr. Clay Gangwisch, Dr. Mike Grandy, Dr. Daniel Melzer, Dr. Andy Holtery, and Dr. John Miller or other oral health specialist who provides treatment

Waiting Period– A specified amount of time that the patient must be enrolled with an insurance plan before it will pay for certain treatments; waiting periods may be waived if you were previously enrolled in another dental insurance plan with a different carrier

There are many different insurance options available, so you need to find out exactly what your insurance covers. It’s important to review your plan with a qualified insurance specialist. Don’t be afraid to ask questions about the policy so you can understand it fully and be confident that you know everything your policy covers the next time you come in for treatment at our Lynn Haven or Panama City Beach office.

November Marks National Diabetes Awareness Month

November 1st, 2018

Diabetes is a chronic disease that increases the risk for many serious health problems, including severe gum disease. November is Diabetes Awareness Month, and it’s a great time for us at Bay Smile Docs to remind our patients that the way you care for your teeth at home doesn’t just affect your oral health; keeping your mouth healthy is vital to your overall health, too.

Diabetes is the result of a deficiency, or lack of the hormone insulin to properly transport glucose (blood sugar) to the cells throughout the body. According to the American Diabetes Association, the most common types of diabetes are Type One (90-95 percent of cases), Type Two (five percent), and gestational or pregnancy diabetes. Women who have had gestational diabetes have a 35 to 60 percent chance of developing diabetes, mostly Type Two, in the ten to 20 years following their pregnancy.

In the past decade, researchers have found links between periodontal (gum) disease and diabetes. Not only are people with diabetes more vulnerable to gum disease, but diabetes may also have the potential to affect blood glucose control, as well as contribute to the advancement of diabetes.

Nearly 26 million Americans currently live with the disease, with an additional 79 million in the pre-diabetes stage. There is some good news we want you to know, however; you can protect your gums and teeth from the effects of diabetes by visiting our Lynn Haven or Panama City Beach office for an exam. Patients who are living with diabetes may require more often visits to ensure their dental health remains in tip-top shape. Many insurance plans provide expanded benefits for diabetic patients, and Dr. Clay Gangwisch, Dr. Mike Grandy, Dr. Daniel Melzer, Dr. Andy Holtery, and Dr. John Miller can tell you how often you need to come in for an appointment.

For more information on how we can help, please do not hesitate to give us a call at our Lynn Haven or Panama City Beach office.

The Intriguing History of Halloween

October 25th, 2018

Halloween is fast approaching, and Dr. Clay Gangwisch, Dr. Mike Grandy, Dr. Daniel Melzer, Dr. Andy Holtery, and Dr. John Miller wanted to be sure to wish our patients a happy day, no matter how you might celebrate this holiday. The Halloween that is familiar to most people today bears little resemblance to the original Halloween; back in the "old days" it wasn't even called Halloween!

Festival of the Dead

Halloween started out as a Celtic festival of the dead that honored departed loved ones and signified a change in the cycle of the seasons. The Celtic people viewed Halloween, then called "Samhain," as a very special day – almost like our New Years day in fact, as their new calendar year began on November 1st. Samhain was the last day of autumn, so it was the time to harvest the last of the season's crops, store food away for winter, and situate livestock comfortably for the upcoming cold weather. The Celts believed that during this day, the last day of winter, the veil between this world and the spirit world is the thinnest, and that the living could communicate with departed loved ones most effectively on Samhain due to this.

Modern Halloween

Halloween as we know it today started because Christian missionaries were working to convert the Celtic people to Christianity. The Celts believed in religious concepts that were not supported by the Christian church, and these practices, which stemmed from Druidism, were perceived by the Christian church as being "devil worship" and dangerous.

When Pope Gregory the First instructed his missionaries to work at converting the Pagan people, he told them to try to incorporate some of the Pagan practices into Christian practices in a limited way. This meant that November 1st became "All Saints Day," which allowed Pagan people to still celebrate a beloved holiday without violating Christian beliefs.

Today, Halloween has evolved into a day devoted purely to fun, candy, and kids. What a change from its origins! We encourage all of our patients to have fun during the holiday, but be safe with the treats. Consider giving apples or fruit roll-ups to the kids instead of candy that is potentially damaging to the teeth and gums.

Remind kids to limit their candy and brush after eating it! Sweets can cause major tooth decay and aggrivate gum disease, so to avoid extra visits to our Lynn Haven or Panama City Beach office, make your Halloween a safe one!

Teeth Grinding Can Damage Your Teeth

October 18th, 2018

Grinding of the teeth, also known as bruxism, is a serious condition from which nearly ten percent of Americans suffer. It’s a mechanical reflex that often happens during slumber. Unfortunately, most people don’t recall grinding their teeth when they awaken.

This makes it difficult to catch the condition before serious damage occurs. Some people notice soreness in their jaw, shoulder and neck pain, or even headaches. Others aren’t so lucky and don’t feel any pain until a professional notices they have developed cracked teeth, receding gums, and jaw problems.

Dr. Clay Gangwisch, Dr. Mike Grandy, Dr. Daniel Melzer, Dr. Andy Holtery, and Dr. John Miller and our team hope to prevent teeth grinding before serious health concerns arise. Let’s go over the reasons for grinding as well as preventive tips to help you feel better fast.

Why do you grind your teeth?

The most common reasons for teeth grinding include:

  • Stress
  • Anxiety
  • Aggression
  • Poor muscle control
  • Acid reflux
  • Sleep apnea
  • Complications from certain disorders

It’s worthwhile to understand the reason you’re grinding your teeth, but it’s even more vital to treat the issue quickly. You can take measures to alleviate the pain you may be experiencing, such as applying a warm wash cloth to your jaw, taking muscle relaxants, massaging the jaw muscles, visiting a chiropractor, or doing physical therapy.

Prevention

To protect your oral health and jaw bones, try these preventive measures:

  • Reduce the amount of stress in your life
  • Drink plenty of water every day
  • Avoid chewing gum or chewy foods
  • Get plenty of sleep each night
  • Reduce or stop alcohol and caffeine consumption
  • Get a custom mouthguard from Bay Smile Docs

Dr. Clay Gangwisch, Dr. Mike Grandy, Dr. Daniel Melzer, Dr. Andy Holtery, and Dr. John Miller and our team want to make sure you’re properly treating your teeth grinding issues. Feel free to call our Lynn Haven or Panama City Beach office if you think you may be suffering from this condition, or have questions regarding a treatment plan.

Teeth grinding can lead to far more serious health issues, and should be ended before it becomes a major concern.