You make monthly payments for your dental insurance, and you vaguely understand that it’s an important thing to have. But are you truly making the most out of your investment? Many people aren’t fully aware of how dental insurance works, and end up overpaying for or avoiding the care they need as a result. Luckily, it’s easy to save money on dental care if you understand a few basic insurance concepts. Here are four tips from a dentist in San Antonio on how you can maximize your dental insurance benefits!
1. Understand the 100-80-50 Rule
Although every dental insurance policy differs slightly, most of them use a similar framework when it comes to which types of treatments qualify for which levels of coverage. In general, you can expect yours to follow this basic structure:
- Preventive services like checkups, X-rays, and cleanings are typically 90-100% covered.
- Basic treatments like fillings and gum disease therapy are usually 70-80% covered.
- Major restorative procedures like root canals and dental crowns are often covered at 40-50 percent.
2. Know Which Out-of-Pocket Expenses You’re Responsible For
Even with dental insurance, you’re still responsible for a few out-of-pocket costs, including:
- Deductible – Your deductible is the amount you’ll have to pay before your insurance company begins covering your dental care under the 100-80-50 framework.
- Premium – Every quarter, month, or year, you’ll need to pay a certain amount to keep your insurance plan active.
- Copay – Each time you check in at your dentist’s office, you’ll typically be responsible for a small, fixed fee.
3. Don’t Let Your Annual Maximum Go to Waste
After you’ve paid your deductible, your insurance company will start covering the costs of your treatments according to their specific guidelines. They’ll devote a set amount of money per year to covering your care. This amount is called your annual maximum, and it’s often upwards of $1,000. When a year ends and a new one begins, any unused benefits left on your annual maximum will NOT roll over. Not to mention, your deductible will reset. To prevent your benefits from going to waste, complete any dental work you need before the end of the year.
4. Schedule a Dental Checkup Before the Year Ends
Practically every dental insurance policy fully covers the cost of two checkups and cleanings per year. These routine appointments are not only quick and affordable, but they’re an easy way to treat oral health issues early on or even prevent them entirely. If you were to wait until your teeth hurt to visit your dentist, then you’d probably have to pay for expensive procedures that could have been avoided!
Dental insurance may seem confusing, but once you learn the basics, you’ll be able to save time and money by taking full advantage of your coverage. If you still have questions about dental insurance, feel free to call your dentist – they’d love to help!
About the Author
Dr. Zachary Brice is a dentist in San Antonio who prides himself on building genuine relationships with patients, ensuring their care is as personalized as possible. His team at Brice Dental is always happy to help patients save on their care by filing insurance claims on their behalf and maximizing their benefits. To learn how you can make dental care more affordable with insurance, contact Dr. Brice at 210-903-5565.