Many Americans have dental insurance either through their job as a benefit or through a different provider. Dental insurance provides coverage to individuals as well as their families. It can be invaluable in helping you cover the cost not only of your routine dental visits, but also restorative dental procedures. In this article we will cover some of the basics of how dental insurance works. Obviously, every dental insurance program is unique, so if you want more direct answers about your specific coverage, we recommend checking with your insurance provider.
Dental insurance companies often classify different dental procedures into different large groups. Generally speaking, more coverage is offered to medically necessary procedures like preventative and restorative dental services. Preventative services include most procedures handled at a regular dental visit. Dentists across the country recommend that you see a dentist twice per year or every 6 months. During this visit, the cleaning, the x-rays, and the other services like dental sealants are all considered preventative as they work to prevent cavities and gum disease. During your visit, if dental decay needs to be handled with a root canal, dental crown, or a tooth needs to be replaced with a bridge, these would be considered restorative procedures. Because they are often medically necessary, they are either fully or partially covered.
No, many dental insurance companies do not provide full coverage for every procedure. Specifically, procedures like orthodontic or cosmetic treatments are usually not fully covered. In terms of orthodontic procedures, some insurance companies will provide a pay cap per patient per lifetime. So that money can only be used once towards braces or another orthodontic solution. Many cosmetic dental procedures like teeth whitening are either not fully covered or not covered at all.
A “deductible” refers to how much money a patient or insurance holder has to pay before the insurance company begins to pay. So if you have a deductible as part of your insurance plan, you will need to pay that amount for your dental services before the insurance program begins coverage. AFter the deductible is paid your insurance will either fully cover or partially cover any additional costs.
If you live in the Revere Massachusetts area and need to set up a dental appointment for you or someone in your family, please give us a call, we would be happy to get you an appointment at our office in revere.