Use it or lose it! When it comes to dental insurance, that’s the name of the game. Unfortunately, billions of dollars worth of benefits are lost each year because people don’t maximize the benefits they’ve paid for. In fact, a recent study by the American Dental Association found that the average person has an annual benefit of $1,250, but only gets about $323 of dental work each year. That means losing over $900 that could go towards achieving a healthy, beautiful smile. In this blog, you’ll get tips for taking advantage of your benefits and learn about what procedures are usually covered at a dentist in Denton. Learn more below!
How Can You Get the Most From Your Insurance Plan?
Your first step should be to find out when your plan year starts and ends. Most plans start January 1st and end December 31st, but there are a few that begin and end on a fiscal calendar year.
Also, check your deductible so you’ll have a better idea of your total cost for a procedure. You can also ask a dentist to file a preauthorization beforehand for a more specific figure. This formal estimate from your insurance company will give you a breakdown of the coverage they’ll provide, so there won’t be any surprises.
And, since many dental office schedules fill up quickly at the end of the year, it’s a good idea to schedule any appointments as soon as you can.
Which Procedures Are Usually Covered By Insurance?
Since there are hundreds (if not thousands) of insurance plans out there, be sure to check your individual plan to see what percentage of each procedure is covered. With that said, here are some average coverage figures:
- Cleanings, X-Rays and Exams – These are considered preventative and are typically covered at 80%-100%. Most patients get 2 checkups a year, although more frequent checkups might be covered for patients who have diabetes, cancer, gum disease or are pregnant. Also, some plans cover professional fluoride treatments (which are excellent for cavity prevention), so always check your benefits.
- Deep Cleanings – Recommended for patients with gum disease, deep cleanings are usually covered at 60%-80%.
- Fillings, Crowns, Root Canals and Bridges – Whether you see a general or emergency dentist in Denton, insurance plans will likely cover 50%-80% of restorative care costs.
- Orthodontic Care – Many plans will cover between 20% -70% of orthodontics.
- Miscellaneous – Things like night guards, athletic guards or sedation are often covered at 20%-50%.
Finally, don’t forget that most insurance plans have an annual maximum for each member (usually $1,000-$3,000), which is the amount of money that they’ll pay for dental work each year. Don’t be a statistic in 2018 – use (instead of lose) your benefits!
About the Author
Dr. Todd Balington is a general, restorative and cosmetic dentist in Denton who wants to help everyone get the dental care they need. His office is in-network with many different insurance plans to make care accessible for as many patients as possible. If you have any additional questions about your dental insurance, he can be reached via his website or at (940) 383-3300.