Your smile is one of the first things that people will notice about you—meaning that it’s in your best interest to take great care of your pearly whites! One of the best ways you can do this is by having (and taking advantage of) dental insurance benefits. Here’s a little more insight into what types of dental insurance plans are available and what each plan typically covers, so that you can set your smile up for lasting health and beauty.
What Types of Dental Insurance Plans Are Available?
Here are a few of the different types of dental insurance plans:
- Preferred Provider Organization (PPO) – If you have a PPO plan, you have the option to visit a dentist either inside or outside of your insurance provider’s network. However, you’ll often have lower out-of-pocket costs if you stick with an in-network practice.
- Dental Health Maintenance Organization (DHMO) – DHMO plans work a little differently. In contrast, they require you to visit a dentist that your provider has approved. If you seek care outside of the approved list of specialists, you might not be covered by your plan.
- Discount dental plans – These programs provide you with a pre-negotiated rate that you can expect to pay if you receive dental care from a select group of practices. Even though none of your services are technically covered, you’ll still get a considerable discount on the care you do receive.
What Does My Dental Insurance Plan Cover?
Most dental insurance plans operate on a 100-80-50 coverage structure, meaning that certain procedures and treatments are fully covered, and others are only partially covered. Here’s a breakdown:
- 100% coverage – Preventive care is often fully covered by dental insurance plans, as regular checkups and cleanings are an inexpensive way to prevent serious and costly issues from progressing. These visits include routine oral examinations, X-rays, plaque/tartar removal, and more.
- 80% coverage – Minor restorative care is usually covered up to 80% after your plan’s deductible. While some plans might interpret “minor restorative care” differently, services covered often include things like dental fillings, simple extraction, and other noninvasive procedures.
- 50% coverage – Major services such as oral surgeries, restoration options like crowns or implants, root canal therapy, and more are often only covered by up to 50% of a plan’s maximum. In some cases, these total costs can exceed your plan’s maximum, necessitating the need to schedule treatment for the following year as well (assuming coverage doesn’t lapse).
Knowing exactly what your dental insurance plan covers can make seeking out and scheduling treatment a much easier process. If you’re uncertain about whether or not you’re covered for a particular procedure, don’t hesitate to ask your dentist—they’ll be happy to help you maximize your benefits.
About the Practice
The team at Allen Smile Design is honored to serve patients and families in the Allen, TX area under the leadership of Dr. Tonie C. Lewis. The practice is proud to offer a wide range of available services including preventive, cosmetic, restorative options and more. If you have any questions about the article or would like to arrange a visit, you can contact the practice online or over the phone for assistance: (972) 954-9728.