Dental insurance has become essential in today’s world where dental treatments have become expensive.

However, understanding what’s covered and what’s not covered under your dental insurance is crucial in avoiding any surprises and ensuring that you receive the dental care you need. In this article, we will help you understand dental insurance by answering some commonly asked questions.

What is covered under dental insurance?

Dental insurance provides coverage for preventive and basic dental procedures, including:.

Regular checkups twice a year
Cleanings
X-rays
Fillings
Simple tooth extractions
Fluoride treatments
Sealants

Some policies may also cover major procedures such as root canals, dental crowns, bridges, and dentures. However, the amount of coverage for these procedures may vary depending on the policy.

Moreover, many policies have limits on the number of procedures covered and the frequency of coverage. It is important to read the terms of your policy carefully to know what is covered and what is not.

What is not covered under dental insurance?

Most dental insurance plans do not cover cosmetic procedures such as teeth whitening, veneers, and braces. Similarly, procedures considered medically unnecessary, such as tooth reshaping and gum contouring, are not covered.

Moreover, dental insurance may not cover treatments for pre-existing conditions, any damage caused by neglect or intentional harm, and dental implants. It is advisable to read your policy’s terms of service to understand what exactly is not covered.

What is a deductible?

A deductible is the amount you pay out of pocket before your insurance covers the rest of the charges. Deductibles vary according to policies, but they usually range from $50 to $150 per year.

For example, if you have a policy with a $100 deductible and undergo a $500 dental procedure, you will pay $100, and your insurance will cover the remaining $400.

What are co-payments?

Co-payments are the fees you pay towards dental services after your insurance covers its share of the cost. The amount of the co-payment varies according to services and policies and can usually range from 20% to 50% of the total cost.

For example, if you undergo a filling that costs $100 and your policy requires you to pay 20% co-payment, you will have to pay $20, and your insurance will cover the remaining $80.

What are annual maximums?

An annual maximum is the total amount of money your insurance policy pays toward your dental care within a year. This amount usually ranges between $1,000 and $1,500 per year.

Once you reach your annual maximum, you will be responsible for paying the remaining dental care costs until the beginning of the following year, when your annual maximum resets.

What is a waiting period?

A waiting period is the time you must wait before being eligible for coverage of certain dental procedures. Many policies require a waiting period of six to 12 months for major procedures such as root canals and dentures.

It’s essential to understand the waiting period of your policy to avoid any surprises and make informed decisions about your dental health.

What is the difference between in-network and out-of-network coverage?

Dental insurance policies differ in the dentists and dental clinics which they cover. A dentist or dental clinic that is a part of your insurer’s network charges you less than dental practices that are outside the network.

Visiting an out-of-network dentist or dental clinic may result in paying higher out-of-pocket costs. To know which dentists and clinics are in your network, you should check with your insurance company or browse their website.

Conclusion

Dental insurance is a valuable tool that ensures that you and your family receive regular dental checkups and affordable dental care.

However, understanding the coverage terms of your policy is essential in avoiding any surprises and receiving the dental care you need. Make sure to read the terms and conditions of your policy and ask your insurance representative any questions or concerns before making decisions about your dental health.