Serenity Smiles

How Dental Insurance Works

July 8, 2021
|
Posted By: Serenity Smiles
Stamp of approval on top of dental insurance papers

Dental insurance is a must-have, but it can also be very confusing for many. Terms like maximums, deductibles, networks, and so on can leave you scratching your head. So, instead of second-guessing, you have to know the following points I discussed below.

What Is Dental Insurance?

Like any insurance, dental insurance covers dental work expenses. It helps individuals pay for their dental care, so they can have the perfect smile without breaking the bank.

Moreover, this includes a set of covered conditions and procedures. It has but is not limited to dental X-rays, surgery, fillings, cleaning, and more. The coverage range depends on your chosen policy.

Some of the most comprehensive dental insurance policies include orthodontic treatments, root canals, and expensive gold fillings. However, this also entails a higher premium cost.

Note that many policies will dictate how many times you need to go to the dentist. It's important to take advantage of your coverage to get the most out of your money.

Terms Used in Dental Insurance

To help clear up your confusion, the following are some of the terms you'll encounter in a dental insurance policy:

  • Deductibles. This is the set amount you must pay before the insurance company starts covering the expenses. For example, if you have a $100 deductible, your insurer will only start paying the excess at $101 forward.
  • Coinsurance. This clause will require you to pay a percentage of the cost based on the indicated procedure. This kicks in once the deductible is met.
  • Waiting period. This is the period before certain procedures are covered.
  • Preauthorization. Under this clause, you have to seek approval from your insurer before a specific treatment is performed.
  • Annual maximum. This is the amount your insurer will pay for a year. Once you reach this limit, you'll have to pay for all dental costs after that.

Type of Dental Insurance

There are three common types of dental insurance plans. These are the following:

  1. Discount plan. A discount plan is the most pocket-friendly option for those on a budget. However, the plan only grants you discounts, and they don't pay for anything.
  2. Preferred provider organization (PPO). PPO dental plans have a roster of dentists who will accept the insurance. With this, you can only go to an in-network dentist to enjoy all the plan's perks. It also provides the biggest savings.
  3. Health management organization (HMO). Similar to PPO, HMO has a network of dentists that accepts the insurance. This plan requires you to pay a set fee.

If you already have a dentist, you can look for an insurance plan where they are members. This way, you no longer have to look for another dentist.

Conclusion

Understanding dental insurance will let you enjoy the benefits even more. Feel free to talk to your insurance agent and dentist to find the best plan for your needs. The best thing is that most dental teams are willing to help you realize the full perks of your plan. This way, you can flaunt a beautiful smile without digging into your savings.

If you have difficulty using our website, please email us or call us at (480) 400-5000
View the ADA Accessibility Statement