You may be surprised to learn that dental insurance coverage is completely different from medical insurance. In fact, many patients get confused about what their plan actually covers because they don’t understand how it works. Dental benefits can vary from person to person, which is why it’s incredibly important to review the details of your specific insurance. Fortunately, we’re here to help! Read on as a dentist in Chesterton shares a basic outline as to what the average dental insurance plan covers.
Types of Dental Insurance
First and foremost, you must know what type of dental insurance plan you have. Here are some of the most common ones:
- Preferred Provider Organization (PPO) – With this plan, you have more flexibility when choosing a doctor or hospital. They provide you with a list of preferred in-network dentists. However, you can go out-of-network if you’re okay with paying the extra costs.
- Dental Health Maintenance Organization (DHMO) – This plan provides a network of dentists that have agreed to set dental insurance rates, including copays. You won’t have a benefit maximum or deductible, but you’re only limited to in-network providers.
- Dental Discount or Dental Savings Plan – These plans allow members to choose from a select group of participating dentists who charge lower rates for their services. It’s worth noting that none of your care is covered by insurance – you simply pay the entire discounted rate out-of-pocket.
What Does Dental Insurance Usually Cover?
Although every dental insurance plan is unique, most of them usually follow a 100-80-50 structure for coverage. Not sure what that means? Let’s take a closer look at how it works:
- 100% – Preventive dentistry is essential for a healthy smile. Services like oral examinations, teeth cleanings, oral cancer screenings, and routine X-rays are often fully covered under every plan. You don’t have to worry about a large (if any) out-of-pocket cost!
- 80% – More standard treatments like fillings and periodontal therapy are covered at a slightly lesser percentage than preventive dental services.
- 50% – Complex dental procedures like root canal therapy, dental bridges, dental crowns, and tooth extractions typically have the least amount of coverage.
Hopefully, this guide will help you better understand what your dental insurance plan covers. Now that you know a bit more about our policy, you can make the most of it and take all steps necessary to keep your smile healthy!
About the Practice
At Advanced Dental Concepts, we offer high-quality and comprehensive services to patients of all ages. Our team values patient education to ensure you make well-informed decisions for your oral health. If you have any questions about your dental insurance, don’t hesitate to reach out. You can contact us via our website or call (219) 926-7595.