Many people avoid their dental office not because they have a dental phobia, but because they don’t want to have to deal with the complicated task of dealing with their dental insurance. Unfortunately, over time, not being proactive about keeping up with your smile can lead to hefty dental bills due to invasive treatments. Read on to learn how dental insurance works and the best ways to get the most out of your plan.
Important Dental Insurance Terminology
Before you delve into the ins-and-outs of dental insurance, it’s important to know a few keywords that apply to most plans:
- Deductible. The deductible is a set price determined by your insurance company that you have to pay out of your pocket before they’ll begin covering services.
- Maximum. The maximum is an annual cap of how much your insurance will pay out for your treatments.
- Premium. The premium is a monthly or annual amount you pay to receive benefits.
- Waiting Period. A waiting period is a set period of time before you can receive full coverage for specific procedures.
How is Coverage Determined?
One of the things that makes dental insurance so complicated to navigate is that no two plans are the same. This means that your coverage can vary, so the best way to be sure about whether a certain treatment will be covered is to directly ask your insurance provider. That being said, most companies determine coverage based off of a 100-80-50 structure. This means they cover 100 percent of preventive visits, like your bi-annual checkups and cleanings, 80 percent of basic treatments like cavity fillings, and 50 percent of more invasive procedures, like dentures and root canal therapy.
How Can I Save the Most Money Using Dental Insurance?
Due to the 100-80-50 coverage structure, the best way to save is by utilizing your covered preventive visits and being proactive about caring for your smile. Some people don’t visit the dentist until they experience a toothache or something that would be considered an emergency, but when you wait this long for problems to fester, it will most likely result in you needing an invasive, only partially covered procedure. With a good oral hygiene and preventive care routine, you can save your wallet from steep out-of-pocket costs, all while navigating your dental insurance benefits to the fullest!
About the Practice
At Smile More Dentistry, our dentists believe in accessibility, which is why we’re proud to be in-network with most major PPO plans, including Aetna, Guardian, MetLife, and more. For patients who don’t have insurance, we also offer a Smile Savings Club program. For a low monthly payment, all of your preventive care is covered, including two checkups and cleanings per year, and X-rays! For questions or to learn how we can help you maximize your insurance benefits, call us at 845-675-1512 or request an appointment on our website.