Delving into the details of your dental insurance plan may not sound exciting, but understanding your coverage is certain to make you smile! That is because knowing the ins and outs of your dental insurance plan can help you maintain a healthy mouth and save you money! From key terms, to typical coverage rates, to handy tips to maximize your benefits, here is how to get the most out of your dental insurance.
3 Key Definitions to Know
Here are three important terms to understand if you want to evaluate and understand your dental insurance plan:
- Deductible – The minimum amount you must first pay out of pocket before your dental insurance kicks in. For example, if the deductible on your plan is $100, your insurance will only begin covering your dental care costs after you have paid the first $100.
- Co-Pay – Once the deductible is met, your dental insurance will cover a portion of the bill. However, you are responsible for paying the remainder of the bill – this portion of the bill is called the co-pay. Co-pays can range anywhere from 20% to 80% of the total bill, depending on your level of coverage and what procedure has been done.
- Yearly Maximum – An important thing to keep in mind is that most dental insurance policies have a maximum amount of coverage in a year. Once a patient reaches the yearly maximum – which can range anywhere from $750 per year to $2,000 per year – they must pay for 100% of any remaining charges.
What is Typically Covered?
The details of dental insurance plans can vary widely depending on a range of factors, so be sure to read the fine print of yours. However, dental plans often cover the following procedures like so:
- Preventive dental procedures – Most dental plans cover 100% of the cost of exams, cleaning and X-rays.
- Basic restorative procedures – Depending on your plan, you may be reimbursed up to 80% for procedures such as root canals, fillings and extractions.
- More extensive restorative procedures – Many insurance plans cover up to 50% of extensive restorative dental work, such as crowns, orthodontia or fixed and removable bridges.
Tips to Maximize Your Benefits
Here are a couple handy tips to maximize your dental insurance benefits and keep more of your hard-earned money in your wallet:
Tip #1: If you are considering more extensive treatment (e.g., a dental implant), the perfect time to get started is after you have met your annual deductible but while your annual coverage remains. Under this scenario, your out-of-pocket will likely be dramatically reduced!
Tip #2: If you are getting close to your insurance policy’s annual maximum, however, beginning more extensive treatment near the end of the year is recommended. This way, you can split the cost across two years – using up your remaining dental benefits this year and then taking advantage of your renewed benefits in 2020.
Putting your dental insurance to use will help keep you smiling in 2019 and beyond! If you have additional questions about what is covered and what is not under your plan, talk to a dentist in Beverly today.
About the Author
Dr. Robert Blake has been helping members of the Beverly community achieve and maintain healthy smiles for over 30 years. Along with the expert team at Beverly Farms Dental, Dr. Blake is happy to help any patient better understand their dental insurance benefits. Patients looking for stress-free, quality dental care can visit the Beverly Farms Dental website or call Dr. Blake at 978-927-3515.