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What Does Dental Insurance Cover?

December 25, 2023

Filed under: Uncategorized — therouxdental @ 4:40 pm

Close up of hands covering a molarOver 156 million Americans have dental insurance, but less than 3% of people will meet or exceed their annual limits in 2023. Let’s face it, dental insurance can be confusing because it works differently than your medical coverage. Don’t throw money in the trash. Here’s how your dental insurance works and what you can do to maximize your coverage before it expires.

How Does Dental Insurance Work?

Paying your premiums gives you access to a nationwide network of dental professionals. Dental insurance focuses on prevention to stop common oral health problems, like cavities and gum disease. Research has found that $1 of preventive dental care can save up to $50 on restorative and emergency services. As a result, you’ll save money down the road while keeping your teeth and gums healthy. With oral health and general wellness closely connected, you’ll invest in a healthy mouth and body.

Your dental insurance offers the coverage you need to keep your mouth healthy for reduced out-of-pocket expenses, including:

Preventive Dental Care

You can benefit from 100% coverage for preventive dentistry after a co-payment, which includes:

  • Oral Checkups and Screening
  • Routine X-Rays
  • Cleaningings
  • Fluoride Treatments
  • Dental Sealants

Basic Restorative Care

If your dentist finds anything concerning, like tooth decay, you can use your benefits to partially cover the cost. Your insurance can pay 80% of the expenses after meeting your annual deductible for services including:

  • Dental Fillings
  • Simple Tooth Extractions
  • Gum Disease Treatment
  • Root Canal Therapy

Major Dental Work

If you need extensive dental work, your benefits may cover up to 50% of the expenses until reaching your annual limit for services like:

  • Crowns and Bridges
  • Partials and Dentures
  • Dental Implants
  • Surgical Tooth Extractions 
  • Oral Surgery

In-Network VS. Out-of-Network Dentist

Your dental insurance recommends choosing a dentist in their network to enjoy more coverage at the time of services. They have pre-negotiated rates with preferred dental practices for select services. You can still use your dental insurance at an out-of-network dentist to enjoy more treatment options; however, you may pay more out-of-pocket. You’ll be responsible for the difference between the dentist’s fees and your insurance’s allowable amount.

Your Dental Benefits Expire

Unfortunately, your dental insurance doesn’t last forever. It expires at the end of the year, and you’ll lose anything you haven’t used, including your annual allowance. Nothing will carry over and you aren’t reimbursed for your premiums or deductibles. 

There’s still time to use your dental coverage before it resets. Head into the new year with a healthy, beautiful smile.

About Dr. Tina Theroux

Dr. Theroux achieved her dental degree from the University of Connecticut School of Dental Medicine and has regularly pursued her education in various specialties, including CEREC, dental implants, BOTOX, and endodontics. She accepts many dental insurance plans to keep dentistry affordable. Request an appointment through her website or call (508) 839-2262.

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