Understanding Dental Coverage & How it Works

Dental insurance policies are a great way to maintain a dazzling smile on a budget. If you already have active medical insurance, understanding dental insurance will be a breeze. Most dental insurance policies are pretty straightforward and specific when it comes to the procedure they cover and your out-of-pocket amount. Some medical insurance plans include dental insurance – if yours doesn’t, you can get a stand-alone policy.

Here Is a Breakdown of How Private Dental Insurance Works

While picking your dental insurance plan, make sure you pick one that includes your existing dentist or preferred dentist and falls within your budget:

Already have a dentist you like? If they are in the insurance network you’re looking at, you can easily opt for a less expensive plan.

If you don’t have a dentist, you can find a plan that fits your budget and includes highly rated dentists in the network.

The monthly premiums of your insurance plan depend entirely on your location, chosen insurance provider, and the plan you decide to go ahead with. For many people, the monthly premium comes out to be around $50 a month, adding up to around $600 a year, with or without any visits to the dentist.

What Kind of Dental Procedures Do Dental Insurances Pay For?

Dental insurances group procedures into 3 categories of coverage for easy understanding – basic, preventive, and major.

The majority of the dental plans cover 100% of preventive cases like your semiannual or annual visits for X-rays, cleaning, and more.

80% of the cost of all basic procedures like gum disease treatments, fillings, extractions, and root canals are covered with co-pays, deductibles, and coinsurance determining the patient’s out-of-pocket expenses.

Dental insurance only covers major procedures such as inlays, crowns, bridges, and dentures at 50% of the procedure cost, adding the remainder to the patient’s out-of-pocket expenses.

It is important to know that the kind of procedures included in the three categories defers based on the insurance provider and their policies.

What Isn’t Covered by Dental Insurance?

Most dental insurance policies do not cover non-necessary cosmetic procedures like tooth shaping, teeth whitening, veneers, or gum contouring. Why? These procedures are targeted at making the teeth look better and are not suggested by the dentist out of necessity.