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What Does Your Dental Insurance Plan Cover?

October 11, 2022

Filed under: Uncategorized — murphydental @ 5:38 pm
dental insurance form on table

An estimated 77 million Americans have dental insurance coverage through an employer or group program. Because it doesn’t work the same way as a typical medical insurance plan, it can be difficult to understand. Knowing how your policy works is essential for maximizing your coverage. Luckily, we’re here to help! Continue reading to learn about the most common types of dental insurance plans and what to expect in terms of coverage.

Types of Dental Insurance Plans?

There are many different types of dental insurance plans to choose from. Some of the most common ones include:

  • Dental Health Maintenance Organization (DHMO) – Your insurance provider gives you access to certain doctors and hospitals that will accept your plan for a set co-pay or fee. However, you won’t receive coverage if you see a dentist that’s not on this list of in-network dentists.
  • Preferred Provider Organization (PPO) – With a PPO plan, you have the option to choose which provider you’d like to see from a list of dentists that are in-network. While you can choose one that’s out-of-network, it’ll likely result in higher out-of-pocket costs.
  • In-House Dental Plan – Although this is not a dental insurance plan, it’s a great alternative. The plan is usually offered directly by the dental practice, allowing you to save on certain treatment options for an annual fee.

What Does Dental Insurance Usually Cover?

Although every dental insurance plan is unique, most usually follow a 100-80-50 structure for coverage. Generally, that means they will cover the following dental treatments and procedures:

  • 100% of Preventive Care – Services include regular cleanings, checkups, routine X-rays, and more.
  • 80% of Basic Procedures – Standard procedures like fillings, gum disease treatment, and other non-invasive procedures.
  • 50% of Major Procedures – More complex treatments like root canal therapy, dental crown placement, and tooth extractions fall into this category.

How to Make the Most Out of Your Dental Insurance

You may be surprised to learn that plenty of Americans leave almost $1,000 worth of dental benefits unused by the end of their coverage period. Don’t let that be you! Here are some ways to maximize your benefits:

  • Contact your insurance provider to review the details of your policy and confirm your coverage
  • Make sure you get all the preventive dental care you need
  • Schedule restorative treatment as soon as possible
  • Remember your benefits have a deadline so you need to use them before you lose them

Now that you know a bit more about your dental insurance coverage, you can the steps necessary to keep your oral health in its very best shape!

About the Practice

At Murphy Dental Home, we strive to help every patient achieve their happiest, healthiest smile. Our practice will always go above and beyond to ensure you get the care you deserve. If you’d like to learn more about your dental insurance coverage, don’t hesitate to ask. You can reach a member of our team via our website or call (972) 449-5120.

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