More than half of Americans currently have some sort of dental insurance. However, many people aren’t entirely aware of the ins and outs of their plan. As a result, they may not end up getting the care they need, or they might accidentally pay too much for it. To make the most of your dental insurance, it’s important to understand a few basics. Continue reading as a dentist in Center explains some basic dental insurance terms and what services you can expect to be covered.
Basic Dental Insurance Terms
All of the technical-sounding language that your dental insurance company uses can be overwhelming when you don’t exactly know what it means. Here are a few important terms you should know to make it easier to understand your policy:
- Deductible: What you must pay out-of-pocket before your insurance coverage kicks in.
- Annual maximum: The highest amount your insurance company will pay for your care in a given period (typically a calendar year).
- Premium: The amount you pay the insurance company every month to qualify for benefits.
The 100-80-50 Rule
While every insurance plan is different, most of them follow a 100-80-50 rule when it comes to which services are covered. You can generally expect your coverage to look something like this:
- Preventive and diagnostic care, like checkups, cleanings, and oral cancer screenings, are usually covered at 80%-100%.
- Basic treatments, including fillings and gum disease therapy, are often up to 70%-80% covered.
- Major procedures, such as root canals and dental crowns, are ordinarily only covered up to 50%.
Services may fall under different categories with different plans. To understand your full list of which services are covered and to what extent, you’ll have to talk to a representative from your insurance company or a member of your dental team.
How to Make the Most of Your Dental Insurance
Multiple studies have indicated that the vast majority of Americans with dental insurance leave almost $1,000 worth of benefits unused at the end of their coverage period. More often than not, any benefits you haven’t used yet will not carry over into the next year. To prevent your annual maximum and your premiums from going to waste, schedule any dental work you need before the year ends. Plus, regular preventive care that’s covered by your insurance can help you avoid larger dental bills in the future. Two routine checkups and cleanings a year lets your dentist catch small problems before they require more invasive and expensive treatment.
These simple basics should be enough to help you get the most of your dental insurance. If you still have questions, though, a member of your dentist’s team should be more than happy to help.
About the Practice
At Family Dental Center of East Texas, our dentists prioritize preventive care to keep your smile healthy in the long run. Dr. Thomas Youngblood and Dr. Mireya Martinez are both active members of the American Dental Association and the Texas Dental Association. Our practice will file claims for the vast majority of dental insurance plans. To learn more about what your dental insurance covers, contact us at (936) 427-9070.