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Health Insurance Basics

Dental Insurance Basics That Will Help You Save

May 14, 2018

Did you know that dental health affects your whole body? Luckily, dental insurance is available to save you money on necessary dental care, whether it’s cleanings, x-rays, or crowns. You can buy dental insurance either as a standalone policy or, in many cases, as part of your health insurance plan.

Dental Insurance Provides Many Benefits

Purchasing full coverage dental insurance provides many benefits to people above and beyond protecting their smiles. That’s because dental insurance:

  • Promotes oral health. Today’s dental professionals are all about prevention. Regular dental exams make it more likely that any problems can either be prevented or treated before they lead to bigger, more painful issues.
  • Saves money. Dental insurance is inexpensive compared to paying out-of-pocket dental costs for preventive and basic care.
  • Offers financial protection in case of dental emergencies. Urgent problems like a chipped tooth, dental abscess or broken crown can be uncomfortable and expensive. Dental insurance can lessen the sting of unexpected dental expenses.
  • Protects the whole body. The Academy of General Dentistry notes that 90% of the body’s diseases often first show signs and symptoms in the mouth.
How Dental Insurance Works

Dental plans work very much like health plans do. Once you purchase a dental insurance plan and start paying your premiums, most preventive care like cleanings and check-ups will be covered immediately.

For more complicated procedures, you’ll need to meet your deductible first. After that, you’ll only need to pay a percentage of the cost. Your dental plan will pay the rest.

The same health plan lingo you already know applies to dental insurance, too, including:

  • Deductible – The amount of money you’ll have to spend out of pocket before coverage kicks in.
  • Copays and coinsurance – The portion you pay for visits and treatments. Copays are a flat dollar amount, while coinsurance is usually a percentage of the total expense.
  • Out-of-pocket maximum – This is the most money your plan requires you to spend on your dental care. If you reach the out-of-pocket maximum, your dental plan will cover 100 percent of your dental expenses.
What’s Not Covered?

Just like health plans, even full coverage dental insurance plans also have some limitations on the services they cover. For example, if you choose to have any cosmetic dentistry done, expect to pay for it in full. This includes procedures like teeth whitening, gum contouring, and veneers.

Braces may be covered but expect limitations including a payment cap. In fact, many plans have a dental benefits cap, known as the annual maximum benefit, report. You’ll need to pay 100 percent of expenses that exceed your annual maximum benefit, although some plans will allow you to roll over a portion of the unused annual maximum to the next plan year.

Stay in Your Network

Just like with your health plan, you’ll save the most money if you see a provider in your plan’s network. That’s because dentists who are in-network have agreed to accept the rates negotiated by your plan. Dental professionals who aren’t part of your plan can charge a different rate, which could cost you much more. Consider this:

  • In network - Most dental plans cover cleanings and check-ups at 100 percent when you go to a dentist in your plan.
  • Out of network - Dental procedures, cleanings, and preventive care all cost more when you see a dentist outside your plan.

Your best bet is to stay in your plan so you can maximize your savings while keeping your smile bright!

Academy of General Dentistry Know Your Teeth website: Warning Signs in the Mouth Can Save Lives. (Rev. January 2012)