Two of the top reasons why people avoid visiting the dentist are because of anxiety and a fear of what treatments will cost. Dental insurance in particular has been known to be confusing and daunting to deal with, which is why it’s a great idea to visit a dental office that will help file claims for you and ensure you receive the most out of your coverage. To learn more about how your plan works and better understand its limitations and benefits, read below.
Yearly Maximum
Most dental insurance plans renew January 1st of every year, and at that time, the deductible and yearly maximum will renew. The maximum is the capped-off limit that your dental insurance company will pay for your treatments throughout the year. Once you meet this amount, your insurance will no longer pay out for treatments, requiring you to take on the rest of the balance. While every dental insurance plan is different, most have an average annual maximum of between $1,000 and $2,000.
Deductible
Similarly to the yearly maximum, most plans also have an annual deductible. This is the amount of money your insurance company will require you to pay out of pocket before your benefits apply. Typically, the higher your premium (the amount you pay monthly for your dental insurance plan), the lower the deductible. One important detail to keep in mind when it comes to your deductible is that it doesn’t typically apply to preventive procedures like routine checkups and cleanings. The average dental insurance deductible is about $50.
Benefits Check
Before you agree to move forward with a dental treatment like a filling, crown, or root canal procedure, the front desk staff at your dental office will conduct a complimentary benefits check with your insurance. This will allow them to provide you with a cost estimate that shows you about how much your plan will cover of the procedure, and how much you’ll be expected to pay out-of-pocket.
Covered Treatments
Every dental insurance plan is different, so if you’re concerned about what treatments are covered under your benefits, it’s best to get with your insurance coordinator at your dental office or contact your insurance company directly to ask. That being said, most plans use a 100-80-50 coverage structure. This means that they cover 100% of the cost of routine preventive care like checkups and cleanings, 80% of basic treatments like cavity fillings, and 50% of major restorative procedures.
Understanding your dental insurance plan will help you maximize your benefits at every turn and avoid out-of-pocket expenses along the way. With the assistance of your dental team in Rockville, utilizing your insurance will be easier and more transparent than ever.
About the Practice
At Rockville Family Dentistry, our front desk staff is happy to assist you in utilizing your dental insurance at every appointment. Not only are we in-network with most major PPO dental insurance plans, but even if we’re not in-network, we’ll help you file insurance claims to maximize your reimbursements. If you have questions about whether or not we accept your insurance, we encourage you to visit our website and use our dental insurance checker, or call our office at 301-816-9400.