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With a good dental insurance plan, you’ll have a much easier time fitting your family’s oral health care into your budget. But exactly what kind of procedures will your insurance help pay for? The exact answer can vary from plan to plan, but many of them do follow a similar structure. Below is a basic outline of the coverage you can expect from the average dental plan.
Preventive Dental Care
Preventive care is the main focus of dental insurance; you can expect most plans to provide up to 100% coverage for these types of services. This is to encourage patients to seek the dental care they need to avoid costly emergencies, which can allow them (and their insurance company) to save a lot of money.
You can expect your plan to allow for at least two teeth cleanings and oral exams a year. Standard coverage usually also pays for X-rays at least once a year. Other preventive services such as fluoride treatment may be included as well.
Basic Dental Care
Dental insurance usually pays around 80% for basic restorative care. This typically includes services meant to address basic dental issues. Fillings are a good example of a basic procedure that is included under most plans. Tooth extraction can also potentially fall under this category, although this only applies to simple extractions.
Major Dental Care
“Major” dental care refers to more in-depth procedures. The coverage for major care is usually around 50% and may include the following services:
- Dental crowns used to repair and protect damaged teeth
- Root canal therapy for treating tooth infections
- Dental bridges and dentures for replacing teeth
- Surgical tooth extraction for teeth that are impacted or have broken off at the gumline
Just like with basic dental care, the definition of major dental care may not be exactly the same for every plan.
Orthodontia
Some plans do include coverage for braces and other forms of orthodontia. In many cases, this coverage can be used for both children and adults; however, some plans will only pay for children’s orthodontia. Bear in mind that the maximum for orthodontic care is usually separate from the maximum for dental care.
What Isn’t Covered Under Dental Insurance?
Most insurance plans only pay for services that help restore, improve, or maintain oral health. They do not usually cover elective procedures such as teeth whitening or other forms of cosmetic dentistry. There are exceptions, however, so it’s worth double-checking with your insurance company.
Knowing the basics of dental insurance can make it much easier to navigate your plan. If there’s anything that you don’t understand, remember that you can always speak to the team at your dental practice; they work with various insurance companies regularly and can answer any questions you might have about the specifics of your coverage.
About the Author
Dr. David C. Parsons has been practicing dentistry for over 40 years and has spent most of it right here in his hometown of Winfield. He’s proud to help his friends and neighbors enjoy the benefits of state-of-the-art dental care. His practice is in-network with Blue Cross Blue Shield and Delta Dental, and he’s happy to accept other insurance plans as well. To schedule an appointment with Dr. Parsons, visit his website or call (620) 221-0730.