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4 Tips for Understanding Your Dental Insurance

October 13, 2020

Filed under: Uncategorized — windermereteam @ 4:48 pm
Confused man has questions about dental insurance

If you have dental insurance, you probably know that it’s important, but do you understand how it works? Unfortunately, many people don’t and end up avoiding, delaying, or overpaying for their dental work. Thankfully, understanding your dental insurance may not be as difficult as you think! Read on as your Cummings dentist explains four basic tips that will help you figure out your dental insurance and make the most of your benefits.

1.) Keep in Mind Your Annual Maximum and Deductible

Two very important parts of your dental insurance you should keep in mind are your annual maximum and deductible:

  • Annual maximum: This is the most your dental insurance policy will pay for your dental treatments in a single pay period (which is usually one calendar year).
  • Deductible: This is the amount of your dental care that you’ll need to pay out-of-pocket before your dental insurance begins to pay for your treatments with your annual maximum.

Generally speaking, plans that have lower deductibles also have lower annual maximums, while higher deductibles usually come with higher annual maximums.

2.) Remember the 100-80-50 Rule

While every dental insurance policy is somewhat unique, most follow something called the 100-80-50 rule when it comes to covering the costs of various dental services:

  • 90-100% of preventive and diagnostic treatments, such as checkups and cleanings.
  • 70-80% of basic restorative services, like root canals, fillings, and extractions.
  • 45-50% of major procedures, including dental crowns, bridges, and dentures.

3.) Always Ask for a Pre-Determination of Benefits

Keeping the 100-80-50 rule in mind can help you predict what the cost of your care will be. However, anytime you’re getting a treatment that goes above and beyond a dental checkup or basic filling, you should ask your dentist to send a pre-determination of benefits to your insurance company. Once they process your estimate, they’ll send back a statement that outlines exactly how much and what parts of your treatment your insurance policy covers. This can help you plan for your dental care and avoid any unpleasant surprises when it’s time to pay for it.

4.) Don’t Let Your Dental Checkups Go to Waste

Like most dentists, dental insurance companies put an emphasis on prevention. That’s why nearly all policies will cover the cost of two routine dental checkups twice a year. These quick and easy appointments are designed to spot and stop oral health issues you may not have noticed yet before they progress into much larger, more complicated, and more expensive problems. Even if your teeth look and feel fine, you should plan on visiting your dentist every six months to ensure your oral health stays on track. Not only will this help you avoid dental emergencies and other conditions, but it’s one of the best ways to make the most out of your dental insurance.

Remember, every dental insurance policy is different, so you’ll need to go over the details of your plan. Your dental team would be more than happy to review this information with you and help you maximize your benefits.  

About the Practice

Dentistry at Windermere has been serving smiles of all ages in Cummings and the surrounding communities with award-winning care since 2003. They firmly believe that optimal oral health should be an achievable goal for everyone, which is why they accept all traditional dental insurance and PPO plans, file claims on their patients’ behalf, and ensure that dental insurance benefits are always maximized. In addition, they also offer a variety of special offers and discounts, as well as financing options through CareCredit. To see how affordable caring for your smile can be, don’t hesitate to contact them via their website or at (770) 205-1212.  

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