Most dental procedures are costly, which makes it hard to pay out of pocket. Luckily, there is a helping hand we call dental insurance. You can get it as part of a medical insurance plan or buy it separately from the Marketplace or a dental insurance company. But “How does dental insurance work?” let’s find out:
What Is Dental Insurance?
Dental insurance helps pay for dental care. You usually pay a premium for coverage unless your employer provides it for free. These plans often have deductibles, copayments, and coinsurance that you pay when you get care.
You might need to use dentists in the insurance company’s network, and there is usually a limit on how much the plan will pay. Many people get dental insurance through their jobs, and it’s usually separate from health insurance. You can also buy individual or family dental insurance directly from insurance companies.
How Does Dental Insurance Work for Procedures?
Dental insurance usually covers three types of procedures: preventive, basic, and major. Each policy can group these procedures differently and might not cover all of them. It’s important to know what each policy covers when comparing them.
-
Preventive Dental Services
Most dental plans cover 100% of preventive care, like annual or semiannual visits for cleanings, X-rays, and sealants. These are the most commonly covered procedures and usually have no waiting period. Typically, you are allowed 2-3 cleaning and routine exam visits per year.
-
Basic Dental Services
Basic procedures include treatments for gum disease, extractions, fillings, and root canals. The deductibles, copays, and coinsurance determine your out-of-pocket costs. Most policies cover 80% of these procedures, with patients paying the remaining 20%. There are usually waiting periods of 6 to 12 months before you can get these treatments.
-
Major Dental Services
Major procedures, like crowns, bridges, inlays, and dentures, are typically covered at 50%, meaning you pay more out-of-pocket. Some policies treat root canals as major procedures, while others classify them as basic and cover more of the cost. Waiting periods for major work, such as crowns, dentures, and bridges, are typically 12 months but can vary with plan.
This means you need to stay with the same insurer for that time. Patients needing expensive procedures should look closely at dental insurance details. For example, a single dental implant can cost $3,000 to $6,000. Many basic dental insurance plans don’t cover implants and those that do have limits and exclusions. Because of this, many people choose insurance plans that cover implants.
What Does Dental Insurance Not Cover?
Dental insurance usually does not cover the following:
- Cosmetic dentistry
- Teeth whitening
- Some dental insurances might cover Orthodontics (braces) but have a lifetime maximum benefit (check your policy for details). They might cover it with a lower percentage.
What Is a Good Deductible for Dental Insurance?
A good dental insurance deductible is usually between $25 and $100 per person each year, which is much lower than medical insurance deductibles.
Once you meet the deductible, dental insurance often covers 80% of basic services and 50% of major services. Many plans also have an annual maximum payout, like $1,000. After you reach this limit, you pay 100% of any further costs for the year.
They usually fully cover preventive services like cleanings and dental exams. Therefore, they don’t count towards the deductible to encourage regular dental care.
Wrapping Up
Dental procedures are costly. That’s why it’s good to have a beneficial insurance policy. Understanding “How does dental insurance work?” helps you make the most out of your insurance plan.
Visit our dental professionals at Almond Dental. Our dental practice accepts most dental plans for your convenience. Call us at (612) 782-7000 or (763) 762-7177 for an appointment.