Dental insurance can be a real tooth-saver. But despite its usefulness, many people don’t understand what exactly their plan covers. Thankfully, though each policy differs from patient to patient, there are typically some general guidelines that all plans follow. Here’s a closer look at dental insurance, and what kind of coverage your plan could provide.
Preventing Problems: Emphasis on Preventive Care
Unlike medical insurance, dental insurance places a heavy emphasis on preventive care. This includes things like routine dental exams and cleanings, fluoride and sealants, as well as imaging like X-rays. In some cases, your plan may also cover a set percentage of the cost of other treatments.
In most cases, dental insurance providers take what’s referred to as the 100-80-50 approach, which means they provide:
- 100% coverage for preventive dental care
- 80% coverage for basic dental care
- 50% coverage for major restorative dental care
Dental plans also have a maximum dollar amount that they are willing to pay towards dental care each year, which is typically between $1,000 and $2,000.
Beyond Prevention: Basic Dental Care
Outside of the preventive dental care category, your dental insurance may also cover about 80 percent of the cost of basic dental care, which includes things like:
- Fillings
- Tooth extractions (non-impacted)
- Gum disease therapy
- Root canals
Major Mouthfuls: Major Restorative Dental Care
Finally, major restorative dental care is typically only covered at about 50 percent. This includes procedures such as:
- Dental Crowns
- Dental implants
- Dental bridges
- Dentures
- Complex tooth extractions (impacted)
- Oral surgery
Additionally, some plans may also have partial orthodontic coverage, which usually has its own separate lifetime maximum.
Important Things to Remember About Dental Insurance
Now that you know a bit more about what your dental insurance plan might cover, keep these following factors in mind:
- Dental insurance does not roll over from year to year. Each January 1, your policy, along with your annual maximum and deductible will renew.
- Each plan is different, so make sure you select a policy that covers you and your family’s needs the best.
- Cosmetic services like veneers and professional whitening are usually not covered by dental insurance.
- Choosing a dentist who is in-network with your insurance plan typically provides greater savings than choosing someone out-of-network.
If you have questions or concerns about your specific insurance plan, speak to your plan administrator, call the customer service number on the back of your card, or contact the billing department at your dentist’s office for assistance.
Remember, if you don’t use your insurance benefits, you’ll lose them, so don’t delay in scheduling your important preventive dental care today! Your smile (and your wallet) will be glad you did!
About Our Practice
At Amberly Dental, our skilled and caring duo of dentists want to provide a safe, comfortable place for you and your family to receive high quality oral health care. Whether you need a preventive cleaning and check-up, a basic dental treatment such as a filling, or a major restorative procedure like a dental bridge, we’re ready to help. For questions about your dental insurance coverage, or to book an appointment with Dr. Hull or Dr. Vacek, please visit our website or call us today at 402-786-2007.