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5 Tips for Making the Most of Your Dental Insurance

November 23, 2020

Filed under: Uncategorized — centeronedental @ 10:07 pm
dental insurance form on dark wooden table

You pay premiums for it every month, and you vaguely understand that it’s important, but do you really understand how your dental insurance works? If the technical-sounding language that dental insurance companies use confuses you, you’re not alone. Many patients don’t fully understand the ins and outs of their plans, and end up overpaying for their dental care as a result. Continue reading to learn five tips on how to maximize dental insurance benefits and make the most of your coverage.  

Know the Difference Between Copays and Coinsurance

These two terms might sound similar, but they’re not quite the same. A copay is a flat fee you must pay every time you visit your dentist. Coinsurance, on the other hand, is the percentage of a specific service that you’ll need to pay for. For instance, if your plan comes with 20% coinsurance for fillings, then your insurance will cover 80% of the cost and bill you the remaining 20%.

Learn What Your Annual Maximum and Deductible Are

Your deductible is the amount you must pay out-of-pocket before your insurance coverage kicks in. Once you’ve met your deductible, your insurance company will put a certain amount of money, called your annual maximum, toward your dental care each year.

Remember That “Out of Network” Doesn’t Necessarily Mean “Zero Coverage”

If a dental practice is “in-network” with your insurance, that means they have partnered with the insurance company to make care more affordable for you. However, just because you’re out of network with a practice doesn’t mean you’ll be responsible for the full cost of treatment. It just means that the percentage of your treatment that’s covered might be smaller.

Always Ask for a “Pre-Determination” of Benefits

Before undergoing treatment that goes beyond a routine checkup and cleaning, ask your dental team to send a “pre-determination” of benefits to your insurance company. Later, they’ll send you a statement that shows what percentage of the treatment your insurance would cover. That way, you’ll know exactly how much you’ll be expected to pay out of pocket.

Don’t Let Your Premiums Go to Waste

About 97% of Americans with dental insurance don’t come close to meeting their annual maximums. That means they’ve essentially paid their premiums in exchange for coverage they didn’t even use! To maximize your benefits, see your dentist twice a year for a checkup. Your dentist can detect smaller problems before they worsen into larger issues that require more expensive treatment later on.

Keep in mind that every dental insurance policy is different, so you’ll need to look over your specific plan to find out exactly what it covers. If you need any help, your dental team would be happy review your policy and help you make the most of your benefits.

About the Author

Dr. Raj Vekariya practiced dentistry in India for three years before earning his Doctor of Dental Surgery degree from New York University and beginning to practice at Center One Dental in Canonsburg, PA. His practice is in-network with many, many dental insurance companies, such as Aetna, Delta Dental, and Guardian. To learn more about how to maximize dental insurance benefits, visit his website or call (724) 300-3700.

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