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Do You Know What Your Dental Insurance Covers?

October 25, 2022

Filed under: Uncategorized — rosenfeld @ 7:00 am
Woman looking at dental insurance form on her phone

When you have dental insurance, it’s much easier to afford the care that you and your family need to keep your smiles bright and healthy. But do you know exactly what kind of coverage your insurance company offers? If not, don’t worry; your dental team is here to help! The following post explores what you can typically expect from your dental insurance policy.

What Coverage Normally Looks Like

The coverage you get depends on which insurance carrier you have. That said, most plans tend to follow what’s known as the “100-80-50” structure, which works as follows:

  • Preventive dental care, which includes biannual cleanings and oral exams, is covered up to 100%.
  • Basic care, which may include fillings and a few other treatments, usually receives around 80% coverage.
  • Major care, such as crowns or dentures, is typically covered by around 50%.

This structure is meant to encourage patients to visit their dentist regularly instead of waiting until a problem occurs. By keeping up with your regular dental checkups, you can lower your risk of tooth decay and other oral health issues – and that makes it less likely that you (and your insurance company) will have to pay for costly restorative treatments.

Remember that not all plans have the same definitions of “basic” and “major” care. Some plans might consider root canal therapy to be a basic treatment while others classify it as major, which affects the coverage you can expect for the treatment. It’s always worth double-checking with your insurance carrier to confirm how much you can expect them to pay for a given service.

Is There Anything Not Included Under a Dental Insurance Plan?

Dental insurance is only meant to help pay for dental treatments that protect or improve your oral health. That means teeth whitening and other cosmetic services won’t be included most of the time. However, there can be exceptions. For example, veneers are usually considered to be cosmetic, but in some cases, they can be used to save or strengthen your teeth; in such situations, your insurance company may be willing to help pay for the treatment.

If you get dental implants to replace your missing teeth, you might find that the implants themselves aren’t covered under your plan. That said, many insurance companies are willing to pay for other parts of the process, such as the final restoration.

If you’ve reviewed your plan but still aren’t sure what’s covered and what isn’t, let your dental team know. They work with different insurance plans every day; they can walk you through your plan and help you understand what’s included and what’s not. The more you know about your insurance coverage, the easier it is to use it wisely.

About the Practice

At East Islip Dental Care, you and your family can enjoy the advantages of having six highly talented dentists in one location. Having so many experts in one place means that we can provide everything your smile needs under a single roof. Our practice accepts Delta, MetLife, and various other insurance plans. If you have a question about your insurance coverage, reach out to us today by visiting our website or calling (631) 581-8600.

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