What most people don’t know about their dental insurance plans

By Dr. Shaina Holman and Shantina Alston, our Insurance Coordinator

Dental insurance is nothing like medical insurance. It has different rules and has been largely unchanged in decades despite increasing costs of care. Here are some things to know!

1. PPO* Dental insurance plans allow you to choose your provider. You don’t have to go to an in-network dentist. You may have to pay more for care – but often it is not a huge difference and it is worth it (to most) to feel comfortable with your care. You are paying for a plan that allows you to choose who performs your treatment so do your research and get the best care possible!
*There are certain plans with fee schedules or discount plans that while are considered PPO reimburse very little towards treatment

2. Preventative Care is typically covered- That means very minimal or no out of pocket expense for routine exams, x-rays and cleanings twice per year! Take advantage!! No excuses!

3. Dental benefits do not “roll over”- If you haven’t used your benefits by the end of the year you lose them- you just wasted that money you paid for benefits all year! Don’t let that be you!

4. Yearly maximums- Dental insurance is not true insurance. After you hit your maximum you get zero help with the cost of treatment. Most plans only cover $1,000-$5,000 per year. Sometimes this is even shared among a family! Know your plan. Know the rules and use them to your advantage! If you come in at the end of the benefit year you can be strategic about what to do this year vs. next to maximize that benefit.

5. Deductibles- Many plans have a deductible- meaning you have to pay a certain amount of money out of pocket before your benefits kick in. If you need a significant amount of work done, it is best to do it on the same benefit year so you are not left paying the deductible twice.

6. Dental Savings Plans- Many dental offices (including ours!) offer a dental savings plan for those without dental insurance to help them save money. If we don’t have to deal with the headache of your dental insurance company we are happy to pass that savings in our time onto you! We offer Quality Dental Plan or QDP which covers 2 cleanings, all x-rays, 2 exams and fluoride treatments per year and 20% off for just $349/year and $299/year for each family member. That is way less than most people pay for their insurance plans. No maximums or deductibles too!

Our schedules as dentists fill fast at the end of the year so don’t delay- schedule now so we have enough time to get treatment done if needed to maximize your insurance benefits! We always will call your insurance company ahead of your appointment, get all the details about your plan and help explain that to you and help you take advantage! When work is not covered, we have many financing options to help you afford what you need and avoid a catastrophe. It is very important that you fully understand your insurance plan and coverage details before scheduling care to avoid surprises.