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What Does Your Dental Insurance Plan Cover?

September 8, 2021

Filed under: Uncategorized — villagewalk @ 1:41 pm
dental insurance form on table

Everyone knows how confusing dental insurance can be. Since it’s significantly different from medical insurance, most patients don’t truly understand what their plan covers. Dental insurance benefits vary from person to person, which is why it’s essential to review the details of your unique plan to understand how it works. That being said, your dentist in Chula Vista shares a basic outline of what the average dental insurance plan covers.

Types of Dental Insurance

First, let’s take a look at the most common types of dental insurance plans you have to choose from:

  • Preferred Provider Organizations (PPO) – These plans give you more flexibility when choosing a doctor or hospital. They provide a list of preferred in-network dentists and have fewer restrictions on seeing non-network providers. If you decide to go out of network, it will likely result in higher out-of-pocket costs.
  • Dental Health Maintenance Organization (HMO) – With this plan, you have access to certain doctors and hospitals within its network. But unlike PPO plans, you won’t be able to receive coverage when seeing an out-of-network provider.
  • Dental Discount or Dental Savings Plan – These plans allow members to choose from a select group of participating dentists who charge lower rates for their services. What’s unique is that none of your care is covered by insurance, you simply pay the entire discounted cost out-of-pocket.

What Does Dental Usually Typically Cover?

As mentioned earlier, every dental insurance plan is unique and varies from person to person. However, most usually follow a 100-80-50 structure for coverage – here’s what that looks like:

  • 100% – Usually, all or most costs of preventive and diagnostic care is covered. That includes services like checkups, cleanings, oral cancer screenings, and routine X-rays.
  • 80% – Standard services like fillings and treatment for gum disease are covered at a slightly lesser percentage.
  • 50% – Complex procedures like root canals, bridges, dental crowns, and extractions usually have the least amount of coverage.

Tips to Make the Most Out of Your Dental Insurance

Many people leave almost $1,000 worth of dental benefits unused by the end of their coverage period. Here are some tips to help you maximize your benefits:

  • Review the details of your plan to fully understand what’s covered and by how much.
  • Keep up with your preventive care! Most dental insurance plans allow two cleanings and checkups for little to no out-of-pocket cost.
  • If you need restorative treatment, get it done right away before your condition worsens. Otherwise, you’ll need more complex and costly procedures, which typically have the least amount of coverage.
  • Most benefit plans end on December 31st and won’t roll over into the new year. Use them all before you lose them!

Hopefully, this guide has helped you better understand your dental insurance. That way, you can make the most out of it and maintain a happy, healthy smile for years to come!

About the Practice

At Village Walk Dental, we provide the compassionate, high-quality, exceptional dental care that you deserve. Our highly skilled and knowledgeable team will go above and beyond to give you a smile you’ll proudly show off. If you’re not sure what your dental insurance covers, we’re more than happy to help you understand it. To make an appointment, visit our website or call (619) 482-7367.

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