According to the National Association of Dental Plans, about 77% of Americans have dental insurance of some sort. However, many people aren’t exactly sure how dental insurance works, and as a result, end up not getting the care they need or paying too much for it. To make the most of your benefits, it’s important to know a few basics. Read on as your Murphy dentist breaks down some important dental insurance terms and what services are usually covered.
Important Dental Insurance Terms
If you’re unfamiliar with the “technical” language your dental insurance policy uses, it can feel overwhelming just reading the details of your plan! Here are a few common terms you should know to make understanding your insurance policy easier:
- Deductible: This is how much you’ll need to pay for your dental care before your insurance begins to cover your expenses.
- Annual maximum: This is the highest amount of money your insurance company will pay for your dental care in any given period (usually a calendar year).
- Premium: This is how much you need to pay every month in order to qualify for coverage from your dental insurance.
The 100-80-50 Rule
Every dental insurance policy is unique, but most follow a 100-80-50 guideline when it comes to which services are covered. Generally, you can expect:
- Preventive and diagnostic care, such as checkups, cleanings, and oral cancer screenings are usually 80-100% covered.
- Basic treatments, like fillings and gum disease treatment, are generally covered up to 70-80%.
- Major procedure, including dental crowns and root canals, are typically only 50% covered by dental insurance.
Different services will fall under different categories with different percentages depending on your specific plan. You’ll need to review your insurance paperwork or go over it with your dental team to understand the full list of benefits, limitations, and exclusions.
The Importance of Making the Most of Your Dental Insurance
Studies and surveys indicate that most Americans leave almost $1,000 worth of benefits unused by the end of their coverage period. In most cases, unused benefits don’t roll over into the next year. Make sure to schedule any dental work you need before the year ends to prevent whatever’s left of your annual maximum from going to waste! What’s more, utilizing the preventive care covered by your dental insurance can save you money in the long run. Routine dental checkups and cleanings twice a year can catch problems before they become larger and more expensive issues.
These simple basics should help you make sense of your dental insurance. However, if you still aren’t sure about the details of your policy, your dentist and their team will be happy to help you.
About the Author
At Murphy Dental Home, Dr. Khushboo Gandhi strives to make every aspect of dental care simpler and better. She and her talented team have years of experience helping their patients make the most out of their dental insurance benefits and they’d be happy to go over your specific plan with you as well. They’ll file your claims for you and handle all the paperwork so you can feel relaxed and confident while they care for your smile. If you have questions, Dr. Gandhi and her team can be contacted via her website or at (972) 532-6506.