Paying for dental procedures out of pocket can hamper a person’s finances and discourage individuals from receiving proper care. That’s where dental insurance can help. Many insurance policies are built to deliver reliable dental care at affordable prices. But what’s the difference between policies and how much of your dental care can they cover?
Your Insurance Plan and You
Instead of a typical insurance plan that would cover unexpected costs, dental insurance plans cover anywhere between 50 percent and the entire cost of future services depending on which treatments are provided. While insurance policies differ from company to company, each generally covers three levels of dental care: preventive, basic, and major, while excluding optional cosmetic procedures.
Dental insurance policies are built to encourage preventive care and avoid major complications down the road, which is why many policies offer complete coverage for preventive procedures like routine cleanings and exams.
What Types of Insurance Plans Can I Choose From?
There are three major insurance coverage plans: HMO, PPO, and indemnity plans.
Health maintenance organizations (HMO) policies cover expenses for patients that receive dental care from a select network of pre-approved dentists.
Preferred provider organizations (PPO) are similar to HMO policies but differ in the amount of coverage provided while also allowing patients to receive care from dentists outside their select network at a greater premium.
Indemnity plans allow patients to receive dental care from any dentists but don’t offer similar discounts as HMO and PPO plans.
What is Covered Under Insurance?
Many insurance policies offer anywhere from 70 percent up to total coverage for preventive services. These services include cleanings, exams, and x-rays. Insurance plans usually cover exams twice a year, bite-wing x-rays once a year, teeth cleaning twice per year, and full mouth x-rays once every three years.
For children, many insurance policies cover additional preventive care such as topical fluoride treatment, space maintainers, and sealants to promote dental health and prevent future complications.
What Procedures are Partially Covered by Insurance?
Basic dental services are usually covered for the most part by your insurance plan and can reduce up to anywhere between 50 and 80 percent of costs. Basic dental services include emergency care for pain relief, amalgam and white fillings, necessary tooth extractions, root canal treatment, deep cleaning, re-cementing dental crowns, and additional x-rays.
Major dental services may only be covered by up to 50 percent. Major dental services include dental crowns, inlays and onlays, bridge work, tooth implants, impacted teeth removal, complex oral surgery, anesthesia/sedation, removable partial and complete dentures, denture relines, rebases, denture repair, and orthodontic treatment.
What is Not Covered by Insurance?
Procedures such as Invisalign®, teeth whitening, and veneers can be considered for cosmetic purposes and are usually not covered by insurance policies.
When dental care requires out-of-pocket expenses, many dentists provide the option of financing payment for treatment using their own policies or through third-party companies such as CareCredit. These options make receiving dental care very affordable for many that would otherwise not have access.
Learn More!
Not everyone’s insurance policy is the same. Check with your insurance plan to ensure you know the differences with your policy. For more information about financing dental care, call or visit Allen Dental Inc. and schedule an appointment with our team today!