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What Exactly Does Your Dental Insurance Plan Cover?

October 20, 2022

Filed under: Uncategorized — tntadmin @ 6:29 pm
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Are you one of the estimated 156 million Americans who has dental insurance? If so, do you know how to use your benefits to save as much as possible? Far too many Americans don’t fully understand how dental insurance works, so they end up leaving hundreds or even thousands of dollars in dental coverage on the table every year. To make the most of your benefits, it’s important to know a few basics about what dental insurance covers. Keep reading to learn more!

Dental Insurance Terms to Know

Trying to read the details of your dental insurance plan can feel overwhelming when you’re not familiar with the technical-sounding language your policy uses. To make understanding your coverage easier, it helps to know these three simple terms:

  • Premium – The monthly payment you make to your insurance company in order to keep your plan.
  • Deductible – The amount of money you must pay out-of-pocket before your insurance carrier will begin covering your dental care.
  • Annual maximum – The amount of money your insurance company will put toward your dental expenses in a given period (typically a calendar year) after you’ve met your deductible.

What Dental Services Does Insurance Cover?

No two dental insurance policies are exactly alike, but most of them follow a similar framework when it comes to which types of services are covered to which degree. This is known as the 100-80-50 rule, and it looks something like this:

  • Preventive and diagnostic services, such as X-rays, exams, and cleanings, are usually covered at 100%.
  • Basic restorative care, such as fillings and gum disease therapy, is typically covered at around 80%.
  • Major restorative procedures, such as root canal therapy and tooth extractions, are often covered at around 50%.

Depending on your specific plan, different services may fall under different categories and thus qualify for varying amounts of coverage. Your dental team can help you review your policy’s details and determine how much coverage you can receive for certain services.

How to Make the Most of Your Dental Insurance

When your annual maximum expires (usually on December 31st), any benefits that you haven’t used yet do NOT roll over into the next year. In fact, research suggests that most Americans leave upwards of $1,000 of dental coverage unused at the end of each year!

To prevent whatever coverage you have left from going to waste, make sure to schedule any necessary procedures before the year ends. Additionally, attending two checkups per year will help you avoid the need for extensive treatments in the first place by catching and preventing small issues early on.

Once you have these basics down, it should be fairly simple for you to make the most of your dental insurance and maximize your savings. However, if you’re still unsure about any aspect of your plan, reach out to your dentist’s team. They’d be more than happy to help!

About the Practice

At La Prada Family Dentistry, our dentists in Garland, TX are proud to provide a wide range of dental services to patients of all ages. We even offer Saturday appointments to make dental care extra convenient for busy families! Our practice is in-network with several of the most popular dental insurance plans, but we accept virtually all PPO plans. We would love to help you maximize your coverage. Just contact us today by calling 214-473-5696.

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