A New Employee’s Guide to Medical, Dental Benefits


When you start a new job, one of the most important aspects of your benefits package is your medical coverage. If your plan includes dental benefits as well, all the better. Many large corporations have excellent medical and dental benefits packages that offer full-coverage for everything from preventive to emergency care. If you’re working for a small business, you might have less coverage than you’d like. Either way, if you’re healthy and single, you might consider purchasing voluntary benefits as well. You can subsidize your medical/dental plan with a secondary carrier such as AFLAC.

Company medical and dental coverage plans are typically only offered to full-time employees. Standard plans are structured as HMOs (Health Maintenance Organization) or PPOs (Preferred Provider Organization). HMOs are traditionally cheaper to use but more restrictive than PPOs.

If you have an HMO, you can choose from a list of pre-selected care providers to use as your primary care physician. You are only allowed a certain number of visits per year and referrals are required for specialized treatments. By nature, HMOs are considered fairly cumbersome, since you can’t usually just find a doctor and make an appointment. You have to make sure the doctor is covered and if you have any procedures done, they most often require pre-authorization.

The other kind of employer-provided health plan, PPO, offers more flexibility in that you can choose your own doctors. You will have to pay more if the provider is not within your network, but there are no restrictions as to whom you can see for care.

Understanding Your Coverage
Since medical and dental benefits vary greatly from one company to the next, here are some ways to identify the details of your coverage:

1. Refer to your new employee handbook.
This document will include everything you need to know, from premium costs to coverage for accidental tooth damage. Read this handbook carefully for claims, reimbursement, pre-approval and lifetime maximum payment stipulations.

2. Talk to your HR rep.
Your company’s human resources contact is your first line of education regarding your medical and dental benefits. This representative should be able to answer questions you have as well as recommend options for additional coverage while you’re employed or COBRA coverage if you’re laid off.

3. Ask fellow employees.
Talk to your co-workers about their experiences with the company benefits package. They can tell you how much they’re used to paying out-of-pocket as well as share stories about pitfalls to look out for, if any. While it is not appropriate to ask how much someone at your job makes in salary, it is more often considered acceptable to inquire about specific health care concerns to get an idea of what you can expect. Take your queues from other employees, though. If the office is tight-lipped about benefits, only discuss your questions with HR or your boss.

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