What Can I Do To Maximize My Dental Insurance Benefits?

Dental insurance is a great way to defray the costs of major dental treatment, but it works a little differently than normal health insurance does. There are a few key things you need to know and do in order to get the most from your policy, and in this blog from Origin Dental, we’ll take a look at them. 

1. Find A Dentist In Your Insurance Network

You will almost always pay much less for dental care if you choose an “in-network” dentist. PPO plans let you get out of network care, but this is more expensive, and HMO plans don’t cover out of network care at all.

At Origin Dental, we accept a huge variety of insurances, nearly 2 dozen in total. This includes top names like Aetna, Cigna, Delta Dental, Guardian and many more. Give us a call at (858) 264-2555 if you’d like more information. 

2. Understand How The 100-80-50 Coverage Scheme Affects Your Expenses

Most, though not all, dental policies use a 100-80-50 coverage scheme. This means that the plan will cover:

  • 100% of the cost of preventive care, usually including two yearly oral exams and teeth cleanings as well as one set of x-rays
  • 80% of the cost of basic dental care like fillings or root canals
  • 50% of the cost of major dental care like bridges, crowns, and dentures

While preventive care is totally covered, other procedures will cost you some money out-of-pocket. And the more serious your issue is, the more it will cost to treat it. 

3. Schedule 2 Preventive Appointments Each Year

Since 100% of the cost of two yearly checkups is covered by your insurance policy, you should make sure to come to Origin Dental every six months for an oral exam and teeth cleaning from Dr. Tran. This lets you get the most from your plan and also keeps your mouth healthy. That’s a win-win.

4. Check For Additional Benefits For Kids

For adults, preventive coverage usually only covers oral exams and teeth cleanings. But kids under the age of 18 may qualify for additional 100% coverage for additional preventive treatments like fluoride treatments and dental sealants, which can help prevent cavities. Check your policy for details. 

5. Know Your Yearly Deductible And Annual Maximum 

Your dental plan won’t pay anything toward your care until you reach your deductible, which is usually between $25 and $250. Once you reach the deductible, it will pay out according to your policy details. 

However, your coverage is not unlimited. Most dental plans have an annual maximum of between $1,000 and $2,000. If you exceed this in a calendar year, the plan will stop paying out, and you will pay for the rest of your care out-of-pocket. Keep this in mind when scheduling your dental treatments.

Contact Origin Dental To Get The Dental Care You Need In San Diego

At Origin Dental, we work with most major insurers in San Diego to provide affordable care. And, even if you don’t have insurance, we offer a $95 New Patient Special to get you started, as well as flexible financing through CareCredit and Lending Club. Contact us online or call now at (858) 264-2555 to schedule an appointment with Dr. Tran and learn more.

Enjoy a pain-free visit with sedation dentistry.

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