Do you know what your dental insurance plan covers? If not, don’t worry – you’re certainly not alone. Since it’s notably different from medical insurance, a lot of people get confused about the differences. However, to make the most out of your coverage, it’s crucial to understand the details of your specific plan. With that in mind, a dentist in Fayetteville shares a general idea of what the average dental insurance plan covers.
What Does Dental Insurance Usually Cover?
Right off the bat, it’s important to understand that every dental insurance plan is unique. However, most usually follow a 100-80-50 structure for coverage. Here’s what that looks like:
- Preventive services are typically covered 100%. That includes checkups, cleanings, oral cancer screenings, and routine X-rays.
- Standard procedures like fillings and treatment for gum disease are usually 80% covered, a slightly lesser percentage than preventive dentistry.
- More complex treatments like root canals, bridges, dental crowns, and extractions are only 50% covered, meaning they have the least amount of coverage.
Types of Dental Insurance
Here are some of the most common types of dental insurance you can choose from:
- Preferred Provider Organization (PPO) – These plans give you more flexibility when choosing a doctor or hospital. Even though they provide a list of preferred in-network dentists, you can go out of network if you’re okay with paying the extra costs.
- Dental Health Maintenance Organization (DHMO) – With this plan, you only have access to certain doctors and hospitals within its network that have agreed to set dental insurance rates, including copays.
- Dental Discount or Dental Savings Plan – These plans allow members to choose from a group of participating dentists who charge lower rates for their services. However, none of your care is covered by insurance. You simply pay for the entire discounted cost out-of-pocket.
Tips to Help You Understand Your Insurance
Are you still confused about what your dental insurance covers? Here are some tips to help you out.
- “Out of Network” does not mean “Out of Coverage”. Most dental insurance companies will cover for providers that are in and out of network. The amount of coverage you’ll have for an out-of-network provider may be lower, but you’ll still have coverage, nonetheless.
- Pick your provider. You’re able to choose your dental provider with most plans, so make sure you do your research and settle on a good one!
- Know your plan. As mentioned earlier, dental insurance can vary from person to person. It’s crucial to understand the details of your plan and coverage so you can seek the care that is right for you.
Now that you have a better idea of what your dental insurance plan covers, you can make the most of it and take all steps necessary to keep your smile happy and healthy!
About the Practice
At Lyndon Family Dental, we offer comprehensive, exceptional, state-of-the-art dental services that are bound to exceed even your highest expectations. Our team will go above and beyond to give you a smile you’ll proudly show off. If you need help understanding your dental insurance, we’re more than happy to review your plan and explain your coverage. To learn more, visit our website or call (315) 449-0711.