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How Dental Insurance Differs from Medical Insurance

May 19, 2024

Filed under: Uncategorized — adcchesterton @ 1:03 am

Dental insurance form on deskIf you’ve recently purchased a dental insurance plan, you’ve made a wise investment. You’ll find that your dental insurance works a bit differently than your medical coverage. Here’s what you need to know to benefit from reduced rates for the services you need to keep your mouth healthy.

Premiums, Deductibles, and Annual Limits

Your premiums allow you to benefit from a nationwide network of dental professionals. You’ll have access to the services you need for healthy teeth and gums for minimal expenses. 

Dental insurance is designed to stop common oral health issues from occurring to reduce overall dental costs. If you require any dental work, you must meet your annual deductible before your benefits kick in. Your insurance will cover the expense of medically necessary procedures until you reach your yearly limit. In some cases, your insurance may have a waiting period before you can access all of your coverage.

Dental Insurance Focuses on Prevention

Researchers have found that $1 of preventive dental care can save up to $50 on restorative fees. Routine cleanings and checkups prevent common dental issues, like cavities and gum disease. Therefore, you’re less likely to need costly procedures later. Most dental insurance covers 100% of the cost of preventive care for a co-payment.

Reduced Rates for Restorative Dentistry

If a complication arises, your dental insurance is there for you. After meeting your deductible, your benefits can pay 50% to 80% of common restorative procedures, including dental fillings, crowns, root canal therapy, and dentures. You are given an allowance to use toward the cost of the procedures you need to rehabilitate your dental health.

In-Network VS Out-of-Network Dentist

Your dental insurance will recommend choosing an in-network dentist. Dental insurance companies have pre-negotiated rates with specific dental practices to limit the amount you pay. You’ll benefit from more coverage at the time of service. However, you can still use your insurance at an out-of-network dentist to enjoy more freedom when choosing a dental practice and services. Your insurance will still cover some of the costs, but you may pay more out-of-pocket.

Dental Benefits Expire

Your dental benefits don’t last forever. Your benefits reset at the end of the year, and you’ll lose anything you don’t use. Nothing will accumulate and you aren’t reimbursed for anything, including your premiums or deductibles, even if you never visit the dentist. 

With less than 3% of Americans meeting or exceeding their annual limits, don’t throw money away. Invest in a healthy mouth for minimal expense by maximizing your dental insurance.

About Dr. Danny Hayes

Dr. Hayes earned his dental degree at the Temple University School of Dentistry and is committed to continuing his training to provide the latest solutions in dentistry. He accepts many dental insurance plans to keep a healthy, beautiful smile affordable for everyone. Dr. Hayes is affiliated with many professional organizations, including the American Dental Association and the Chicago Dental Society. Request an appointment through his website or call his office at (219) 2444-2747.

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