Dental Insurance: What Does Your Plan Cover?

November 27, 2022

Filed under: Uncategorized — famdentalcampbell @ 2:44 pm
Glasses on top of dental insurance information sheet

A good dental insurance plan makes it easier to keep up with your biannual visits to the dentist. But do you know exactly what your plan covers? It’s important to be aware of your benefits so that you can use them to the fullest extent possible before they reset. Below is a brief outline of what you can normally expect your dental coverage to look like.

What Coverage is Included Under Most Dental Plans?

While no two dental plans are exactly alike, most of them follow the 100-80-50 rule. Under this structure, you’ll typically receive these benefits:

  • Preventive care is covered up to 100%. This normally includes dental exams, cleanings, and X-rays. In many cases, your dental insurance might even waive your deductible for your biannual dental appointments.
  • Basic restorative procedures are covered up to 80%. What counts as a basic procedure depends on what plan you have, but you can usually expect the definition to include fillings and simple tooth extractions.
  • Major dental services are covered up to 50%. Crowns, bridges, and root canal therapy are all normally considered major procedures, although again different insurance companies will have different standards.

What Services are Not Covered by Insurance?

Most dental plans will only help pay for treatments that protect or enhance oral health. That means cosmetic treatments like teeth whitening usually aren’t covered. There are exceptions, however; for example, some dental insurance companies might be willing to pay for veneers if they’re being used to save damaged or weakened teeth.

It should also be noted that many dental insurance companies will not pay for dental implants, as they are often considered an elective procedure. However, your plan might still help pay for portions of the dental implant process, such as the final restoration and certain preliminary treatments.

How Can You Get the Most Out of Your Coverage?

Once you have a firm grasp of what’s covered by your dental insurance, you can start putting together a plan to maximize your benefits. At the very least, you should schedule two dental checkups and cleanings every year; this will let you use your preventive coverage while lowering the risk of suffering from a dental emergency in the future.

If you develop a cavity or another oral health issue that requires professional attention, you should schedule an appointment to have it taken care of as soon as possible. Dental insurance provides higher coverage for more basic treatments, so you’ll save more money by having your dental problems treated while they’re still small instead of waiting until they require more complex (and costly) care.

Not sure that you understand your dental insurance coverage? Talk to your dental team today. They can review your plan with you and explain the details to give you a better understanding of how you can take full advantage of your benefits.

About the Author

Dr. Allyson Kelly earned her Doctor of Dental Surgery at the Meharry Medical College School of Dentistry in Nashville. Today she provides high-quality dental care for all of her patients at Family Dental Associates of Spring Hill, which proudly accepts many popular dental insurance plans like Delta Dental. To schedule an appointment with Dr. Kelly, visit her website or call (615) 302-1414.

No Comments

No comments yet.

RSS feed for comments on this post.

Sorry, the comment form is closed at this time.