Understanding Dental Insurance
What is dental insurance?
Dental insurance focuses on your mouth and your teeth, whereas medical insurance covers the rest of your body, including your head and neck. Dental insurance is limited to your mouth, tongue, teeth, and that's about it. Anything outside of the mouth is covered by medical insurance. An average dental insurance plan can cost between $25 to $50.
What can impact the cost of dental insurance?
The coverage and what is covered by your dental insurance is determined by negotiations between your employer and the dental insurance company representative. This is why one insurance plan might cover more for a crown than another plan from the same company. It all depends on the negotiations between the employer and the insurance representative.
What are the best dental insurance plans?
The best dental insurance plans are often the best of the worst. Insurances are not designed to cover everything to your benefit, otherwise they wouldn't stay in business. However, some plans do cover more than others. Delta Dental is a good plan, as are Spirit Dental, Guardian Direct, and MetLife, which often have no maximums. Coverage depends on what your employer negotiates with the dental insurance company.
How are root canals and implants covered by dental insurance?
For root canals, dental companies may cover between 40% to 80%. Implants can have limitations, such as a missing tooth clause. This means if you start with a missing tooth, the insurance may not cover an implant. However, if you lose a tooth after obtaining insurance, they might cover the implant. Be aware of missing tooth clauses.
How can you maximize your dental insurance benefits?
Always ask the 800 number or the dental office for a benefits check. In my practice, we offer a complimentary benefits check to maximize your insurance benefits. You need to show up as a new patient.
Depending on your plan, you may have to do the math, as many plans are designed so you pay for your own dental cleanings and exams. You really benefit from dental insurance if you have a year where you need major work, like a crown or root canal, maximizing your insurance benefits.
What are dental insurance benefits?
Most dental insurances offer benefits between $1,200 to $1,800 per year. This hasn't increased since the 1960s, when $1,800 was worth a lot more. Dental insurances cover cleanings, x-rays, exams, fillings, root canals, crowns, and sometimes implants and braces. Medical insurances cover things outside of the mouth. Dental insurance is for everything inside your mouth.
How does supplemental insurance work with dental insurance?
Supplemental insurance provides extra coverage if your main insurance only covers a limited amount per year. Be careful about duplication clauses, as some supplemental insurances may not cover the same treatments. For example, if your main insurance covers $800 of a crown, supplemental insurance may only cover the remainder, depending on their policy. Deductibles may also affect what you owe.
How can I understand my insurance benefits?
Call us when you visit, and we will help you understand and maximize your insurance benefits. Determine what you need and what your insurance covers before signing up, as many people find their coverage is limited after enrolling. Evaluate whether the insurance makes financial sense for your needs.
How do primary and secondary plans work?
Your primary insurance covers your main expenses, and your secondary insurance picks up the rest, up to a certain limit. For example, if you have a $2,000 crown and primary insurance covers $800, the secondary may cover the remainder, subject to their limits. They aim to pay as little as possible.
Does Medicare cover dental procedures?
Medicare does not cover dental as it is considered medical insurance. As people age and stop working, they often lose dental insurance and must pay out of pocket. If possible, avoid plans that restrict you to a network of dentists, as older individuals may need more experienced dentists for complex issues. Unfortunately, mature patients often require more experienced doctors due to complicated dental needs.
We accept the following financing:
5% Discount for cash or check payments at the time of the service.
* Not related to insurance.