November 11, 2018
There’s nothing more frustrating than realizing you passed up a chance to make or save money. But that’s the situation many people find themselves in when they forget to schedule with a dentist before the end of the year. In fact, a recent study by the American Dental Association found that the average person has an annual benefit of $1,250, but only gets about $323 of dental work each year. If you don’t use your benefits, you lose them – and wind up missing out on over $900. Keep reading to find out which procedures are usually covered and how you can maximize your plan this year!
Which Procedures Are Usually Covered By Dental Insurance?
Every insurance plan is different, so be sure to look into your individual benefits to see how each procedure is covered. With that said, here are some ballpark averages for many common procedures:
- Cleanings, X-Rays and Exams – Checkups are considered preventative and are typically covered at 100%. At the very least, everyone in the family should be getting their checkup before the year ends because it won’t cost you anything out-of-pocket! Most patients get 2 checkups a year, but if you’re pregnant or have diabetes, cancer, gum disease, you may get more. Also, check to see if professional fluoride treatments are covered, which are excellent for cavity prevention.
- Deep Cleanings – Deep cleanings are a special kind of cleaning for patients with gum disease, and are usually covered at 60%-80%.
- Fillings and Root Canals – Typically, 50%-90% of the cost of fillings and root canals is covered.
- Crowns and Bridges – Many plans will cover crown and bridgework at 50% – 70%.
What Else Do You Need To Know To Maximize Your Plan?
The majority of plans start January 1st and end December 31st, but some begin and end on a fiscal calendar year, so be sure to double check. If your plan ends in December, try to schedule as soon as possible because many office schedules fill up fast.
Also, check your deductible to get a better idea of your total cost for any given procedure. You can also ask your dentist to file a preauthorization beforehand if you’d like a more specific estimate of your total fees. By getting this formal breakdown from your insurance company, you won’t have any surprises.
Finally, don’t forget that most plans have set aside an annual maximum for each person, usually between $1,000 and $3,000, which is the amount they’ll pay for your dental work. Since it will be lost if you don’t use it, you may as well get the dental care you need – at a greatly reduced cost to you!
About the Author
Dr. Christopher Phillips has over 20 years of experience as a general, restorative and cosmetic dentist. He knows that insurance plans can be difficult to navigate, so he and his staff do everything they can to help their patients maximize their benefits. If you have any other questions about dental insurance, he can be reached via his website or at (440) 354-2183.
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