If you have dental insurance, you may have questions about the way your policy works. Every policy is different, but below we’ve described the way most policies work. This information can help you plan your year of dental coverage, to ensure that you get the most out of your plan.
Typical Dental Procedures Covered by Insurance
Dental health plans can vary, but many plans provide a standard level of care. Under most plans, the following procedures are covered:
- Standard examinations and cleanings (usually twice annually)
- Root canals
- Crowns and bridges
- Emergency dental procedures
- Dental appliances like retainers
Each dental plan may offer different levels of coverage for these procedures, with copay varying from one type of coverage to the next. Often, the more expensive the procedure, the higher the copay for the patient. Many policies have a deductible that must be met before coverage kicks in. Your dental office will be able to tell you when copays are required.
Procedures That Aren’t Usually Covered
Not all procedures are covered under dental plans. Cosmetic procedures are an example of this, as are composite fillings. So if a patient would like a tooth-colored filling, they may be required to pay the difference between the silver filling and the tooth-colored filling. Some other examples of types of coverage that your dental policy will not cover include dental care relating to pre-existing medical conditions and orthodontic treatments like braces or clear aligners.
Your dental office can work with your dental insurance and will likely be able to tell you what your policy does and does not cover. Additional questions can be directed toward your dental insurance.
Expected Costs for Dental Coverage
Dental insurance does have associated costs, especially if you’re seeking coverage outside of an employer plan. Some examples of the type of costs you can be expected to pay include:
- Premium. Dental premiums may be as low as $20 per month, or much higher. The premium costs depend on the level of coverage, your location, the number of people on the policy, and more. If you’re looking for a plan for yourself, try shopping around.
- Deductible. The deductible is a cost that must be paid before coverage will kick in. Deductible amounts and how the deductible works vary depending on the policy.
- Out-of-pocket costs. Out-of-pocket costs vary depending on the procedure and the policy. Once the deductible has been met, some policies will pay for 80% or more of the associated costs, leaving the policyholder with 20% of the cost.
- Amounts beyond the maximum. Most dental plans have an annual maximum amount of coverage they’ll offer. Once the maximum has been met, the patient is responsible for costs for the rest of the year.
- Uncovered expenses. Patients are fully responsible for paying for expenses that are not covered, like orthodontic expenses.
Get the Maximum Benefit from Your Dental Insurance
Start each year getting cleanings when they’re due, to get the most coverage out of your dental insurance. Make an appointment with Weninger Dentistry in Tampa, FL. Call today to make your appointment for a dental cleaning.