How to Get the Maximum Benefits for Your Dental Insurance
Got dental insurance? Are you using it? We hope so.
But if you’re like most Americans, you’re not — or at least not using dental insurance to its maximum benefit. Roughly 47% of Americans participate in an employer sponsored dental insurance plan, according to a 2019 survey by the National Association of Dental Plans. But most don’t use their plans to the fullest. In fact, less than half of insured adults actually use their dental insurance and only 4.2% reach their annual maximum.
And that’s a low down dirty shame because you pay for that insurance plan. Plus, dental health is so critical to your overall health. Yes, dental care can be expensive, but dental insurance substantially brings down the costs to make it more affordable.
Are you getting the maximum benefits from your dental insurance? Here’s what you need to know to take full advantage of your insurance benefits.
Usually Dental Insurance Covers Preventative Care
Preventative care like dental checkups and cleanings can reduce the expense of your dental care overall. If you identify problems early and keep your teeth clean, you’ll face fewer dental issues that could otherwise be more expensive down the road. So it makes sense that your dental insurance covers preventative care. The more you are able to use this preventative care, the healthier your teeth will be and the fewer costs your teeth will face in the long run.
In fact, most dental insurance plans will cover 100% of the cost of cleanings and checkups, or pretty close to it. We suggest you take them up on it. Your teeth will be healthier, and you’ll face fewer issues like root canals, tooth replacement, or dental implants.
Restorative Care Coverage Under Most Insurance Plans
Most dental insurances will cover the majority costs of restorative care — fillings, extractions, and re-cementing of previous crowns and bridges. Usually, it’s around 70 to 80%, give or take. That means you may only need to pay $80 for a $400 filling.
Insurance Coverage for Major Restorative Work
Insurance coverage for major restorative work like crowns, bridges, implants, and root canals are typically covered at 40 to 50%. This is substantially less for these more expensive dental care treatments, but you usually need these treatments less. And the money you’ll save on such procedures is significant.
But that does mean you may still face an expensive dental bill regardless of insurance. We understand — dental care is not cheap. In most cases, we can work out a payment plan for expensive work.
Cosmetic Dentistry Typically Isn’t Covered
Keep in mind that cosmetic dentistry procedures like teeth whitening, veneers, or smile makeovers are not covered under most insurance plans. These you’ll need to pay for completely out of pocket, though again we can usually set up a payment plan if necessary.
Your Dental Insurance Likely Has a Waiting Period
Keep in mind that if you are new to your dental insurance, you likely face a waiting period before your coverage will begin. Preventative care is usually covered immediately, or at least in the first 30 days. Most basic restoration work is covered after 3 months. Major restorative work is typically covered after 6 months. Some insurance plans have a 12-month waiting period for dental bridges, dentures and orthodontia.
You’ll likely need to have your dental plan in effect for at least a year. So forget about signing up for a plan to cover certain procedures and dropping it right after the treatment is completed. Your insurance company will want at least some level of commitment from you to justify their own expenses.
Your Dental Insurance Coverage Doesn’t Roll Over
Most dental insurance plans will cover a certain amount of work in a year, but if you don’t use that money by the end of the year, it doesn’t roll over. That’s why we always encourage our patients to set up a treatment plan to ensure they use their dental coverage to the maximum benefit.
Conversely, once your insurance is used up, your coverage is complete. If you face numerous treatments, you’ll want to plan them in a way that uses the maximum benefits of your plan without exasperating itself, so you are stuck with a high bill.