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Dental Insurance: What is Covered?

October 5, 2022

Filed under: Uncategorized — grandaurora @ 8:01 pm
dental insurance paperwork

Understanding the details of dental insurance can be convoluted. The verbiage, terminology, coverage levels, and available benefits are all essential components of these policies that are designed to help patients save money and improve their oral health. But exactly how much can a person expect to save when using their dental insurance and which services are covered? This article answers these questions while also explaining why it’s best to use these available benefits before they expire. 

Breakdown of Coverage

No two dental insurance policies are exactly the same, but it is true that most companies build their benefits based on the same system – 100-80-50. Although there can be some variations between insurers, it is not uncommon for most patients to find that their preventive services are covered at 100%, while minor and major restorative services are covered at 50-80% depending on the complexity of the treatment.

This is most helpful to individuals who choose to see dentists who are considered in-network with a particular dental insurance company. Because of the pre-negotiations that occur with regard to the services and their fees, patients can expect to pay the lowest price for the care they receive. Deductibles must be met, and annual maximums must have enough funds available for insurance companies to pay more of the total bill, however.

Which Services Are Not Covered?

Since preventive and restorative services are commonly covered by dental insurance companies, it’s unlikely for a patient to receive any additional financial assistance for cosmetic care. These are deemed elective services, so they are not medically necessary and thus, dental insurers will not pay. This is why it is necessary for individuals to determine how they plan to pay for veneers, teeth whitening, gum recontouring, and other aesthetic treatments before they agree to move forward.

Why Use Benefits Before They Expire?

Taking advantage of available benefits through a person’s insurance company will ensure that their smiles remain healthy year-round while also avoiding more serious oral health problems. Although cosmetic services are not covered, filing claims for preventive and restorative treatment will help patients save thousands of dollars each year – money that would normally be returned to insurance companies at midnight on December 31.

Other reasons patients should use their dental benefits before the year is up include:

  • The ability to pay nothing out of pocket for six-month dental checkups and cleanings
  • The opportunity to pursue complex care for less, especially if one has met their deductible for the year

Using dental insurance doesn’t have to be a difficult process. However, should patients find they need assistance in filing claims or better understanding their available coverage, it’s best to talk to a dentist in Aurora who can help them save the most money.

About Grand Dental – Aurora
At Grand Dental – Aurora, our team consists of experts who are committed to taking care of smiles of all types. Offering comprehensive dental care to patients living in Aurora and its surrounding communities, our team is here to provide exceptional service at rates patients can afford. When it comes to filing claims and getting the most out of dental insurance plans, we encourage individuals to visit our website or call (630) 538-8302 to learn how we can help.