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How Does Dental Insurance Work?

September 4, 2022

Filed under: Uncategorized — cherrichdds @ 11:24 pm

Molar, glasses, calculator, and dental insurance formBrushing and flossing are only half the care your smile needs to stay healthy. Your oral health also relies on regular appointments with a dentist. Dental insurance allows you to benefit from the high-quality services you need for affordable rates. While 156 million Americans have dental insurance, less than 3% of people meet or exceed their annual limits. If you don’t use all your coverage before the end of the year, you can lose hundreds to thousands of dollars that could have been spent on your smile. Dental insurance can be confusing, but don’t throw money down the drain. You pay your premiums every month, so why not use your benefits? Here’s how your coverage works to achieve the healthy smile you deserve.

100% of Preventive Services Coverage

Dental insurance focuses on prevention to stop common oral health issues from occurring. Every $1 spent on prevention can save up to $50 on restorative fees by preserving the policyholder’s natural smile. The American Dental Association recommends a cleaning and checkup every 6 months to keep tooth decay and gum disease at bay. You can visit your dentist twice per year after a copayment. Your insurance will cover 100% of the cost of preventive services, including X-rays, cleanings, checkups, and more. 

80% of Minor Restorative Services Coverage

If your dentist finds a problem, you don’t have to stress about a large bill. After reaching your annual deductible, your insurance can pay 80% of the costs for certain treatments, like fillings, dental bonding, or tooth extractions. Your benefits will cover a portion of the cost until reaching your yearly limit, which typically varies from $1,000 to $2,500.

50% of Major Restorative Services Covered

If your smile needs major rehabilitation, your dental insurance can reduce the amount you pay out-of-pocket after reaching your deductible. Although every policy differs, major restorative services include crowns, implants, or dentures. Your dentist will offer various payment options for any remaining balance, like third-party financing with CareCredit. 

In-Network VS Out-of-Network Dentist

Your dental insurance recommends choosing an in-network dentist because they have pre-negotiated rates for common treatments. You’ll enjoy more coverage at the time of care, but you can visit an out-of-network dentist. You can still use your benefits, but you’ll have to pay the difference between the dentist’s fees and your insurance’s allowed coverage.

Your Benefits Don’t Last Forever

At the end of the calendar year, you’ll lose any benefits you haven’t used because your policy resets. Nothing will carry over into the new year, and you aren’t reimbursed for your premiums or deductible. 

There’s still time to use your dental insurance before it expires. Contact your dentist to achieve optimal oral health for minimal expense. 

About Dr. Cher Rich

Dr. Rich achieved her dental degree from the University of Texas at Houston Dental School and has regularly completed continual education to provide modern care. She accepts many dental insurances to keep a healthy smile affordable for everyone. If you need an appointment, contact our office today.

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