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What Does Your Dental Insurance Plan Cover?

October 13, 2020

Filed under: Uncategorized — suwaneedentist @ 6:42 pm
Clipboard with dental insurance paperwork

You pay for your dental insurance every month and you know it’s important, but do you know how it works? Many people don’t fully understand what their benefits cover and end up avoiding, delaying, or overpaying for the dental care they need. Thankfully, learning about the basics of dental insurance can help you save money while keeping your smile healthy! Read on to learn more about what you can expect from your dental insurance coverage.

The 100-80-50 Insurance Coverage Structure

While every dental insurance policy is unique, most follow a 100-80-50 structure for dental coverage. Generally, you can expect certain services to be covered at different percentages:

  • Preventive care, like checkups, cleanings, oral cancer screenings, and routine X-rays, are usually 90-100% covered.
  • Basic treatments, such as fillings and gum disease treatment, are typically covered slightly less at 70-80%.
  • Major procedures, including root canals and dental crowns, are usually only covered at 45-50%.

To see a full list of which services are covered at what percent for your specific plan, you’ll need to review your dental insurance policy paperwork.

Expenses You Are Responsible for

Dental insurance can save you a lot of money on oral health care costs, but there will be some expenses you’ll be responsible paying for, such as:

  • Insurance premium: This is the rate you need to pay to keep your insurance coverage active. Typically, you’ll pay either once a month, quarter, or year.
  • Annual deductible: Your deductible is how much you’ll need to pay for your own treatments before your dental insurance begins to cover them.
  • Co-pays: Every time you visit your dentist, you’ll pay a set co-pay before receiving treatment.

How to Make the Most of Your Dental Insurance

Recent studies estimate that many Americans leave almost $1,000 worth of dental benefits unused by the end of their coverage period, which is when their plan is reset. To make the most of your insurance, schedule any dental work you need before the end of the year so you can use up whatever is left of your annual maximum.

Another great way to ensure you’re maximizing your benefits is to take advantage of the preventive care your plan covers. Most policies will cover two dental checkups and cleanings every year, which is one of the best ways to spot and stop small issues before they become larger, more painful, and more expensive problems. These exceptionally affordable appointments can save you a significant amount of money in the future, so make sure to take full advantage of them.

If you still have questions about what your dental insurance covers, you can call your dentist. They will be happy to review the details of your policy and help you maximize your benefits.

About the Practice

At Dentistry at Suwanee, we’re committed to making quality dental care affordable for the families of Suwanee and the surrounding communities. Our talented team has years of experience handling insurance paperwork, filing claims, and minimizing out-of-pocket expenses for our patients. We also offer discounts for patients without dental insurance as well as low- to no-interest financing through CareCredit. To learn, feel free to contact us via our website or at (678) 381-2875.

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