« Home

Let’s Look At Dental Insurance

A dental insurance plan will help you pay for the cost of your dental work. You need to know how your dental insurance plan is designed and its limitations. Your dental insurance plan is designed to share in your dental care costs. It may not cover the total cost of your dental bill. Most dental insurance plans will only cover between 45% to 80% of your dental services. You may not understand a reimbursement level on your bill. If so, you're not alone. This page will help explain commonly misunderstood features of your dental insurance plan. With most dental insurance plans you will be able to visit the dentist that you want to use. These types of dental insurance plans pay a certain percentage of the dentist's fee or pay the plan the amount that is considered to be reasonable for the service rendered. Just because they pay the amount that is reasonable does not mean that it will cover all the cost of your dentist. Dental insurance has no regulations as to how these reimbursement levels should be, so there is a wider variety in pricing from dental insurance company to dental insurance company. In addition, dental insurance companies are not required to disclose how they determine these levels. The language used in this process may be inconsistent among carriers and difficult to understand. The purchaser makes the final decision on maximum amount of reimbursement through the contract with the dental insurance company. Even though the cost of dental care has significantly increased over the years, the maximum levels of insurance reimbursements have remained the same since the late 1960's. Many plans offer higher maximums that are comparable to rising dental care costs. Your plan may want you to choose your dental care from a list of their preferred providers. Whether of not you choose your dental care from this defined group can affect your levels of reimbursement. Your dental insurance plan may only allow benefits for the least expensive treatment for a condition. For example, your dentist may recommend a crown, but your dental insurance may only offer reimbursement for a regular filling. As with other choices such as purchasing medical or automobile insurance, the least expensive alternative is not always your best option. Just like medical insurance, dental insurance plan may not cover conditions that existed before you enrolled in the plan. Even though your plan may not cover certain conditions, treatment may still be necessary. Your dental insurance plan may not cover certain procedures, or preventative treatments such as sealants that can save you money later. This does not mean these treatments are not necessary. Your dentist can help you decide what type of treatment is best for you. If you have questions regarding your dental insurance plan, or a problem with a reimbursements, talk to your employer or dental insurance company or the dentist, or the office manager at your dental office, they might be able to help explain dental insurance plan issues with you. Sometimes the dentist may not be able to answer specific questions about your dental insurance plan, or know what your amount of coverage for a procedure will be. This is because plans offered by the same employer or written by the same third-party payer can vary according to the contracts involved. The American Dental Association knows the important role dental insurance benefits have played in improving access to dental care for millions of people, and is working with dental insurance policymakers to help set better standards within the industry. If you would like more information regarding dental insurance plans, try contacting the American Dental Association.