Do you have dental insurance? If so, your level of coverage is dependent on what your insurance company and plan defines as “routine care.” If you have insurance, it is a good idea to read your policy and understand what it covers, so you are aware of your responsibilities and options before entering the dentist’s office. It is also a good idea to advise your dentist about which plan you have and, when appropriate, your budget and need to minimize costs.
Is Dental Coverage a Big Issue?
Cost can be a significant factor to many people when considering their options for dental care. Consumer Reports recently reported that “cost was cited as a barrier by 43 percent of readers who delayed dental care.” This is a massive number of people who said they needed to delay oral health care. The survey also says, “Twenty-three percent did so because insurance wouldn’t cover the procedure, and 24 percent did so because they had already used up the maximum that their insurance plan would cover for the year.” When faced with limitations, it is necessary to take the time to understand your dental insurance plan and coverage options.
What Is Covered By a Typical Plan?
Every dental insurance plan is different. Never assume you know what is in yours. In many routine care plans, you will find the following types of coverage:
- There will be a maximum monetary benefit. This may range from a few hundred dollars up to several thousand.
- Most plans provide 100 percent preventative care coverage. This means cleanings, x-rays and dental exams performed one or two times per year will not cost the patient additional money. This, of course, also varies by each plan.
- Many insurance plans also offer specific percentages of coverage for other types of oral care; some examples are deep cleanings, repairing dentures and other procedures.
- More significant procedures may cost more, like fillings and oral surgery; more extensive treatments may also cost more, like root canals and root planing. Once again, a fixed percentage of the costs may be covered.
What Is Not Covered By Most Plans?
Dental insurance often does not provide for most types of aesthetic or cosmetic care. This means procedures like orthodontics or teeth whitening procedures.
To find out what routine care your dental insurance covers, read your policy or call the company directly. Doing this prior to calling or visiting your dentist will prepare you for its costs and arms you with the right questions to ask
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