You pay for your dental insurance every month and you know it’s important, but do you understand how it works? Many people don’t fully know how dental insurance benefits work, and as a result, end up delaying or overpaying for their dental care. In fact, studies estimate that Americans leave thousands of dollars of unused dental benefits on the table every year! Thankfully, learning about the basics of how dental insurance works can help you make the best choices for your smile and your wallet. Here are four practical tips for understanding how dental insurance works.
1.) Keep in Mind What Your Annual maximum and Deductible Are
Dental insurance policies are filled with lots of terms you may not be used to seeing. Two important terms you should know are:
- Annual maximum: This is the maximum dollar amount your insurance company will pay when covering your treatments. If you need care that exceeds your maximum, you’ll be responsible for paying the difference.
- Deductible: This is the amount you’ll need to pay for your own dental care before your insurance coverage kicks in. Once you meet your deductible amount, your insurance will start covering the costs of your treatments according to their coverage schedule.
In most cases, plans with a lower deductible will also have a lower maximum, while policies with higher deductibles usually higher maximums as well.
2.) Remember That Your Benefits Likely Don’t Roll Over
For most all dental insurance plans, any unused benefits you have at the end of your coverage period won’t roll over into the next year. This means however much of your annual maximum is left over at the end of the year will expire when your plan renews. That’s why it’s a good idea to check your deductible and maximum amounts at the end of the year. If you’ve met your deductible but not your annual maximum, you should have any dental work you need completed before January. This way, you’ll pay as little out-of-pocket for your treatment as possible.
3.) Understand What Your Dental Insurance Plan Covers
Every dental insurance policy is different, but most plans follow a 100-80-50 coverage structure. This means that they’ll typically pay for:
- 90-100% of preventive care costs, like diagnostics, X-rays, checkups, and screenings.
- 70-80% of basic treatments, including non-surgical gum disease therapy or fillings.
- 40-50% of major procedure expenses, such as dental crowns or root canal therapy.
4.) Don’t Be Embarrassed to Ask Your Dentist for Help
With so many different types of plans, conditions, exclusions, and expenses, there is still a lot to learn about how dental insurance works. If you’re feeling confused about what your plan covers, what costs you’re responsible for, and how to make the most of your coverage, don’t be embarrassed to ask your dentist for help. They have plenty of experience navigating policy details and filing claims, so they can make sure that you’re maximizing your dental benefits.
About the Practice
At Salmon Brook Dental Associates, we strive to provide affordable, high-quality dental care for all the smiles of Granby and the surrounding communities. That’s why we accept most major dental insurance plans and are more than happy to handle all the paperwork and filing of claims for you on your behalf. For our patients who aren’t happy with their coverage or don’t have dental insurance, we also offer third-party financing options through CareCredit. To see just how affordable caring for your smile can be, feel free to contact us via our website or at (860) 653-4551.