You’ve been told you need a dental filling. How much will that cost? Will my insurance cover it? If my tooth doesn’t hurt, do I really need that treatment? All these questions are running through your mind after your diagnosis, and rightfully so. If only you had a better understanding of how your dental insurance works! Read on, because now you will.
The Basics of Dental Insurance
First it’s important to understand that each dental plan is unique and this information may vary according to your particular plan. If you are unsure about what your plan covers, contact your dentist’s treatment coordinator.
That being said, most dental plans run on a calendar year. This means that they start January 1st, and end on December 31st. Most plans will have a yearly maximum amount they will pay for treatment, typically in the range of $1000 – $2000. Many plans also have a yearly deductible to be met before they will pay for restorative treatment procedures, usually in the range of $50 – $150.
Unfortunately, these benefit dollars don’t roll over into next year’s plan, so if you don’t use them for 2017, you will lose them after December 31st.
Preventive care is typically covered with most dental plans, which means that there is very little, or no out-of-pocket cost for your six-month cleanings and checkups. Restorative treatment is covered at a percentage, which means that while it helps defray the cost of procedures such as dental fillings and crowns, you will still have a portion to pay. Most cosmetic procedures are not covered by dental insurance.
The Importance of Preventive Care
Your preventive appointments every six months are your best defense against issues such as periodontal (gum) disease, oral cancer, and tooth decay. This is because your dentist will screen you at every visit for these concerns, and he or she can typically detect these issues in their very early stages, giving you the opportunity to utilize less costly treatment procedures.
Because your dental insurance covers most of your preventive visits, it is in your best interest to maximize your benefits and go to your dentist twice per year. The goal is that consistent cleanings and checkups will help you avoid the need for more complex dental procedures.
Dental insurance can be confusing to understand! Be sure to discuss your treatment needs with your dentist and contact your office’s treatment coordinator for help in navigating and maximizing your benefits.
About the Author
Dr. Donald Marks and Dr. John Martin lead the team at Donald Marks Family Dentistry. With a reputation for delivering high quality dental care for over 40 years to the communities of State College, PA, patients can trust they are in excellent hands. Patients can rely on a wide range of services at our practice that are tailored to the individual’s unique needs.
If you would like to contact our office, we can be reached by calling 814-234-0329, or through our website.