4 Basic Tidbits You Need to Understand Dental Insurance

According to the old proverb, the only way to eat an elephant is one bite at a time. Simply put, this idiom means that you have to take a huge task or concept in smaller portions, step by step. Otherwise, it is far too overwhelming. The same approach works for the colossal task of understanding dental insurance.

Without delving deep into the terminology and nitty-gritty details of insurance, here are several tidbits of information you need to know to start tackling this enormous, challenging elephant.

Tidbit #1: In-Network Dentists Can Save You Money.

Although you can certainly choose to work with a dentist who is not in your dental insurance’s network, the process is much easier and less financially stressful for you when you choose an in-network provider. Instead of paying the full amount and getting reimbursed later by your insurance company, you can pay just your portion upfront, allowing you to keep valuable funds that can go toward other expenses.

Tidbit #2: Benefits Reset Every January and Don’t Carry Over.

If you’re old enough to remember the days of roll-over minutes for cell phones, you may think the same principle applies to dental insurance benefits—it doesn’t! Every year, you are entitled to two routine dental checkups and cleanings, but if you don’t use both visits before the end of December, you do not carry benefits over to the next calendar year.

In other words, if you have dental insurance benefits, you need to make sure you fit in at least two dental visits within the year to take full advantage of your coverage.

Tidbit #3: Prevention Will Save You the Most Money.

For many, dental insurance can be confusing because it is so different from medical insurance. While your medical plan is designed to reduce your costs for treating major problems, dental plans emphasize the importance of preventing big issues altogether. In fact, most plans pay the full amount for preventive appointments but only between 50 and 80 percent of the cost for tooth repairs, which means you will spend less if you avoid cavities and other problems by seeing the dentist for these routine checkup and cleaning visits every six months.

Tidbit #4: A Knowledgeable Team Can Help You Understand Dental Insurance.

Unless you dedicate your time to learning about dental insurance, it can still be difficult to understand some details. After all, companies can change their policies from year to year. Fortunately, your dental team can stay on top of these changes, be your advocate, and answer your insurance questions. As a result, they can file claims for you, ensuring that you pay the least amount possible in out-of-pocket costs.

Although there is much still to learn about dental insurance, these four tidbits can at least get you going on the path to understanding the basic concepts.

About the Author

Since graduating from the Rutgers School of Dental Medicine, Dr. Bradford Plasha has focused his continuing education coursework on implants and prosthodontics, which means he is proficient at advanced repairs and tooth replacement. However, he encourages patients to prevent issues as much as possible. If you are interested in making an appointment with Dr. Plasha at his practice, The Dental Spot of Collegeville, contact the office online or call 484-559-6094.