Decoding Dental Insurance

Understanding dental insurance can be a tedious process and differs greatly from medical insurance.  In this issue hopefully we can highlight some of the most important features of dental insurance and help

What is Dental Insurance?

That’s a tricky question.  All dental insurances vary by company, coverage and cost.  Dental insurance, much like medical insurance requires you to pay a monthly premium.  By paying that premium you are now contracted with your dental insurer to utilize their fees that they set forth; thus any dentist contracted with your insurance company must comply by charging their fees; anything other than that is considered insurance fraud.

Your insurance company dictates what your co-pays will be, what the dental provider is allowed to charge as mentioned above, and what annual maximum they are willing to cover.

Unlike medical insurance that can have a maximum coverage of $100,000 to multiple million dollars, dental insurance maximums typically range between $1,000 to $2,000 annually.  There is also a catch with the maximum allowance.  All dental insurance companies have certain percentages of what they will cover; for example preventative is typically covered at 100%.  Preventive services are usually exams and cleanings.  Basic services are covered typically from 80 to 100% (typically your composite fillings).  Endodontics, Periodontics, and Oral surgery are typically covered at 50 to 60% (your root canal treatment, extractions, periodontal surgery, etc.)  Major services are usually covered from 0 to 50%.  Crowns fall under this category.  So the question remains for most people; who picks up the remaining percentage for the procedure?  You are responsible for the remaining portion of the procedure rendered; anything other than that is considered a violation of the insurance contract.

How Do I Choose the Right Insurance?

The best way to determine which dental insurance is best suited for you and your family is to ask yourself a couple of questions.  How is my dental health; do I have healthy teeth and gums or have I had ongoing issues?  Secondly, ask yourself what can I afford to pay in premiums and if I didn’t have insurance what could I afford if I had to pay out of pocket for my dental needs?

If historically you have had lots of dental needs then you would want to consider a higher maximum allowance to cover major work.  It would make more sense to pay the higher premium for the higher maximum allowance.  If you have only needed preventative services in the past then a lower maximum policy may make more sense.

What Makes Arvada Dental Center Unique?

Our staff calls on every insurance policy of every patient to get a breakdown of benefits.  This allows us to have the best understanding of what your insurance will pay for and what your responsibly is at the time of service.  If you have questions regarding your insurance company or which one to pick please do not hesitate to ask us here at Arvada Dental Center.


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