When visiting your dentist’s office, you want to pay less for the services you receive. This is common, especially among patients with dental insurance. Knowing how to maximize your savings and take advantage of your available benefits is important, but how much do you really know about your plan? Keep reading to discover 3 key components you’ll want to remember when preparing to pay for care.
Most Benefits Are Good for a Calendar Year
When choosing a dental insurance plan, you can expect your benefits to be good for a single year. The funds you receive from your insurance company (your annual maximum) are available from January to December. If you don’t use this allotted amount within the timeframe, it will be returned to the insurance company, and you’ll lose out on thousands of dollars.
That is why your dentist recommends using your available funds when a more complex procedure is required. If you’ve already met your deductible, you will pay less by completing treatment in the same year.
Dental Insurance Covers Preventive & Restorative Treatment
When using your dental insurance to help cover the cost of care, you can expect it to cover all or part of the services you receive. Generally, 100% is covered for dental checkups and cleanings, while 50-80% is covered for minor and major restorative services.
If you’re seeing an in-network dentist, you will only pay the remaining balance after your insurance pays its portion. However, if you choose an out-of-network dentist, you will pay the upfront cost and file a claim for reimbursement.
Most dental offices that don’t partner with specific plans handle the billing process, so they complete all necessary paperwork correctly and increase your chances of maximum reimbursement.
You Must Pay Your Deductible Before Your Insurance Coverage Begins
Every dental insurance plan comes with an annual deductible, which you must agree to pay before you can expect your insurer to cover their portion of your bill. Whether you see an in-network or out-of-network dentist, you must pay this amount before you can expect either a lower out-of-pocket bill or reimbursement from your insurance company.
It pays to know the details associated with your dental insurance plan. If you have questions, you are always welcome to call your dental team to ask how you can get the most out of your benefits.
About the Author
Dr. Ira Goldberg has more than three decades of experience and is well respected among his peers and patients. Aiming to provide the highest standard of care, he believes patients need the treatment they need, not what their dental insurance dictates. Although he is in-network with Delta Dental Premier, he and our team also file claims for reimbursement for those with out-of-network insurance. To learn how to use your policy to get the best possible service, contact us at (973) 313–5314 to schedule an appointment.