Dental insurance can be difficult to approach for many patients. Attempting to understand the verbiage used as well as the breakdown of coverage can often leave individuals frustrated and looking to anyone for help. Many dental offices now provide experts who can answer questions and address concerns surrounding the intricacies that come with the financial side of dentistry, which is a welcome reality for most patients. But to minimize the number of inquiries a person might have when arriving for their dental appointment, a local dentist is here to explain the general breakdown of coverage for most insurance companies.
Preventive and Restorative Care: What Dental Insurance Will Cover
When looking at a traditional dental insurance policy, a patient can expect to find two columns – in-network and out-of-network. While this is important, another essential component is the percentage breakdown for available services. These typically fall into two categories: preventive and restorative care.
Most dental insurance policies will agree to cover preventive services at 100% because of the emphasis on minimizing dental issues and encouraging patients to be proactive about their oral health. Some of these services can include general exams, cleanings, dental X-rays, and fluoride treatment.
But since sudden injuries and problems can arise at any moment, dental insurance companies also agree to pay anywhere from 50-80% for minor and major restorative services. These can include dental crowns and bridges, fillings, tooth extractions, root canals, and periodontal therapy.
How much an insurer will agree to pay is largely based on whether a patient has met their deductible as well as how much of the available funds are left in their annual maximum. If services were required early in the year but a root canal is now necessary, there may not be enough money left as part of the yearly maximum for a dental insurance company to pay 50% of the total bill. But even if the insurer only pays 30 or 40%, it is less coming out of patients’ pockets.
What Will Dental Insurance Not Cover?
Individuals who are looking to cosmetic dentistry to improve their appearance and boost their confidence will be displeased to learn that dental insurance will not cover these services. Unlike dental crowns and fillings that are necessary to ensure a patient’s oral health does not further deteriorate, cosmetic solutions such as veneers, teeth whitening, and other similar services are elective. This means they do not provide the same urgency as restorative solutions.
Paying for cosmetic dental treatments is then left up to the patient. While paying upfront may not be possible, most dental offices do provide in-house membership plans or flexible financing to keep expenses low.
When meeting with a dentist in Channahon to discuss upcoming treatment, patients are advised to speak to a member of their dental team to identify which services are covered and which are not. This will help individuals determine how best to move forward when it comes to their oral health.
About Grand Dental – Channahon
Grand Dental – Channahon has a team of skilled dental specialists who care about patients and their ability to afford high-quality dentistry. As individuals decide whether to pursue specific treatment, our professionals can identify ways to maximize benefits and ensure out-of-pocket expenses are minimal. For patients who would like to learn more about their dental insurance plans and what they can expect to be covered, visit our website or call (815) 240-9009.