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Helpful Tips for Understanding Your Dental Insurance Coverage

November 4, 2022

Filed under: Uncategorized — legacytrailsdental @ 6:51 am
dental insurance form on table

Since medical insurance and dental insurance are two entirely different things, it’s easy for people to get confused about the differences between them. That means you may not fully understand what your dental insurance plan actually covers. Fortunately, your dentist in Plano has put together a handy guide to help you understand the basics of your policy. Read along to learn a few helpful tips on how to properly navigate your plan.

Understand Your Coverage

Most dental insurance plans offer what’s described as “100-80-50” coverage. This sequence refers to 100 percent coverage on preventive care like checkups and cleanings, 80 percent for restorative treatments like fillings and root canals, and 50 percent for more extensive procedures like crowns and bridges.

Of course, every policy is unique, meaning the exact amount of coverage you’ll receive can vary. If you need help understanding the details of your coverage, don’t hesitate to reach out to your insurance provider or ask your dental team for assistance. 

“Out of Network” Does Not Mean “Out of Coverage”

In the medical world, there are some instances where “out of network” does in fact mean “out of coverage”. If you choose to receive treatment from a provider that’s not in your network, it could mean that none of the costs will be covered by insurance. However, that’s not the case with dental insurance.

There may be little to no difference between what your insurance company will cover for dental providers in and out of network. When you choose an out-of-network dental provider, the percentage of treatment the insurance company covers reduces, but coverage is still available.

Choose Your Provider

Contrary to popular belief, your insurance company doesn’t dictate which dental provider you should be going to. Since you’re the one receiving treatment, it only makes sense that you should be able to decide who you are going to for care. To make the best possible choice for your needs, make sure you look at the difference in coverage between providers. While weighing your options, keep in mind that you may get what you pay for!

Remember That You Are the Customer

It’s crucial to remember that you are the customer of your dental insurance company, not the provider. Any company will reimburse the patient much faster than the practice. If you’re in a situation where you have to pay your dental provider in full, your insurance company will reimburse you directly in just a matter of weeks. It’s strongly recommended that you verify your own benefits, but a dental practice will be more than happy to help you figure it out if needed.

Deciphering the language on your dental insurance can be headache-inducing. However, following the tips outlined above from your dentist in Plano can help you better understand your coverage and take the stress away from receiving the care you need!

About the Author

Dr. Afshin Azmoodeh has been serving local smiles for nearly 20 years after earning his dental doctorate from Texas A&M. A member of the American Dental Association, he is proud to have been a two-time nominee for “America’s Best Dentists.” As your dentist in Plano, Dr. Azmoodeh is ready to help your smile, but first, you are welcome to contact our team to discuss your dental insurance, financing options, or current special offers. Learn more on our website or call us at (214) 227-1000.

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