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Simplifying Dental Insurance: 4 Tips for Understanding Your Plan

November 7, 2020

Filed under: Uncategorized — morganhill @ 9:25 pm
Woman reviewing dental insurance paperwork at home

Having dental insurance is one thing, but utilizing your benefits to the fullest is something else entirely. That task is nearly impossible if you don’t understand the fine print on your dental plan. Since the unfamiliar jargon and pages of paperwork can be headache-inducing, a dentist in Gorham is sharing four helpful tips so you can save as much as possible at your next appointment!

#1. Understand “100-80-50” Coverage

Although dental plans vary from one person to the next, they all are typically centered around preventive care. To encourage patients to visit their dentist every six months for a professional checkup and cleaning, many dental insurance carriers have a “100-80-50” structure where 100% of the cost of checkups and cleanings are covered. As for the “80” and “50,” that’s the percentage that is put toward minor treatments and major procedures respectively.

#2. Learn the Difference Between In-Network and Out-of-Network Coverage

In the world of dentistry, the term “out-of-network” doesn’t necessarily mean “out of coverage.” That being said, there are typically cost-related savings when you stay within your plan’s network. So, it’s generally recommended to see one of the dentists your insurance carrier works with. If you are unsure whether your dentist is in or out-of-network with your provider, just ask!

#3. Utilize Your Annual Maximum

Your annual maximum is the highest dollar amount your insurance provider will put toward your treatment within a given year. Once it’s met, you can expect your out-of-pocket expenses to go up until your plan renews. On the other hand, if you don’t utilize the entire amount, then the unused coverage will turn into wasted dollars when your policy resets because it doesn’t rollover. So, it’s important to know when your annual maximum starts over.

#4. Schedule Treatment Around Waiting Periods

Whether you have an individual plan or one through your employer, you may be tempted to schedule all the treatments you’ve been putting off as soon as you get your card. However, you should hold off just a bit longer if you have a waiting period. For example, if you have a three-month waiting period for root canals, then your benefits toward that service won’t kick in until after that. Therefore, it’s best to schedule your treatment with these restrictions in mind whenever possible.

Although deciphering the fine print on your dental plan can initially be a bit overwhelming, it’s much easier with the above information in mind. Of course, if you need additional assistance, don’t hesitate to reach out to your insurance provider or dental team directly!

About the Practice

The team at Morgan-Hill Dental Care never want cost to stand in the way of the high-quality dental care you deserve. That is why they are happy to accept dental insurance plans from many of the nation’s leading providers. They will even file the claim on your behalf to make maximizing your benefits absolutely stress-free! If you have been searching for a “dentist near me” or have a question about your coverage, visit their website or give them a call at 207-839-2655.

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