Dental insurance can be confusing, especially when it comes to terms like “in-network” and “out-of-network.” While both options give you access to care, they can affect how much you’ll pay out of pocket. Understanding the difference can help you make the most of your benefits—especially as the end of the year approaches and unused coverage expires.
What Does In-Network Mean?
When a dentist is in-network, it means they have a contract with your insurance provider. This agreement allows them to offer discounted rates for covered services. You benefit by paying less out of pocket for preventive visits, fillings, crowns, and other treatments. Choosing in-network care often means:
- Lower copays
- Reduced rates for procedures
- No need to file your own insurance claims
In short, in-network providers make it easier and more affordable to maximize your coverage.
What Does Out-of-Network Mean?
Dentists who are out-of-network do not have a direct agreement with your insurance company. You can still see them, but your costs will likely be higher. Some plans may reimburse part of the treatment fee, while others may not cover out-of-network visits at all. Patients who prefer an out-of-network dentist should be prepared for:
- Higher overall costs
- Paying upfront and filing claims themselves
- Potentially limited coverage depending on the plan
While some people choose out-of-network providers for convenience or personal preference, it’s important to weigh the financial impact.
Why In-Network Coverage Saves You More
In-network dentists typically provide the greatest savings and convenience, which is why insurance companies encourage patients to use them. Preventive services like checkups and cleanings are often fully covered at no additional cost. By sticking with in-network providers, you reduce your expenses while still receiving high-quality care.
Use It or Lose It: Don’t Waste Your Benefits
Most dental insurance plans renew on January 1. Any unused benefits from the previous year do not roll over—they disappear. That’s why it’s important to schedule treatment before the year ends. Using your coverage now allows you to take advantage of the discounts you’ve already paid for through monthly premiums. Delaying care could mean higher costs later or losing valuable benefits altogether.
Knowing the difference between in-network and out-of-network coverage helps you make smarter decisions about your dental care. And with most insurance benefits set to expire at year’s end, now is the perfect time to schedule an appointment and maximize your savings.
About the Practice
Legacy Trails Dental of Plano specializes in personalized, family-friendly dentistry while helping patients make the most of their insurance coverage. Our team is happy to explain your plan, maximize in-network savings, and guide you through affordable treatment options. With a focus on prevention and long-term oral health, we’re committed to helping you maintain a healthy smile year after year.
Call us at (469) 208-6017 or request an appointment online.