Choosing the right dental insurance plan requires doing your research. As a recommended investment for anyone looking to save on oral healthcare, it can minimize how much you pay out of pocket should you need professional dental treatment. But what exactly does it cover and how can you take advantage of its many benefits? Keep reading to discover what kind of savings you can expect when using your dental insurance the next time you visit your dentist’s office.
Covered & Not Covered: What is Included with Dental Insurance?
When comparing dental insurance plans, you’ll find there are many differences, such as the monthly premium, annual deductible, and yearly maximum. This is normal, as each company sets these amounts based on their preferences and cost evaluations.
However, you may be surprised that many companies build their plans similarly. Not only are they largely designed with a 100-80-50 structure, but they emphasize preventive care. Below is a sample breakdown of benefits:
- 100% preventive services – These include dental exams and cleanings as well as X-rays and other similar treatments.
- 80% minor restorative services – These include tooth-colored fillings, routine tooth extractions, gum disease treatment, and more.
- 50% major restorative services – These include custom dentures, dental crowns, complex oral procedures, and more.
What you won’t find are cosmetic dental treatments, which are usually not considered medically necessary for improving your oral health. There are certain exceptions insurance companies will make, though. For example, if you need a metal-free dental restoration to treat a damaged or decayed tooth, they may agree to cover a portion of the cost.
Orthodontics is another category that may or may not be covered by dental insurance. Many companies do not incorporate it, thus requiring patients to purchase a supplemental plan to keep out-of-pocket costs low.
How Can You Take Advantage of Your Dental Benefits?
There are a few important things you need to know when determining how to get the most out of your dental benefits. They include:
- Most dental insurance plans are only good for one year. This means you’ll need to use your benefits between January 1 and December 31, as they do not roll over.
- Seeing your dentist for preventive care every six months will help you save the most money, as it is unlikely to cost you much if anything out of pocket, and you’ll avoid the need for restorative care in the future.
- Should you need a minor or major form of treatment, don’t wait to have it completed. Once you’ve met your deductible, your insurance company will pay more for the service you receive.
Using dental insurance to pay for your oral healthcare needs is one of the best decisions and investments you can make. Know what kind of coverage you have and don’t hesitate to ask a staff member at your dentist’s office for help when preparing to use your available benefits.
About the Author
Dr. Dhiren Ahir leads the team at Prime Dentistry and is pleased to partner with various dental insurance companies to make oral healthcare affordable. As an in-network dentist, he helps ensure the cost of preventive and restorative care remains low, and his team readily files all necessary paperwork and claims forms to take the stress out of patients’ visits. If you want to find out how you can take advantage of your available benefits, contact us via our website or by calling (940) 514-0333.
