Two people in a hallway of a health clinic discussing a patient chart together. Man and woman; office manager and doctor

Dental Insurance 101: What You Need to Know

Dental Insurance is an essential part of dental care.

Will my dental insurance pay for this? It’s a common question we hear at Hale Family Dentistry. Like most insurance plans, they are never as straightforward as we’d like. Luckily, we have been doing this for a long time and can help you sort through it.

Contrary to popular belief, medical and dental insurances are not the same. They vary widely in terms of benefits and coverages.

Explore this all-inclusive resource on dental insurance, covering key aspects such as coverage options, benefit structures, in-network and out-of-network providers, and how to select the right insurance plan for your needs.

Types of Dental Coverages and Plans

Yearly Dental Insurance Maximum

One of the distinguishing factors of a dental plan is the yearly maximum. Typically, most dental insurance plans only cover $1000 to $1500 worth of dental treatment per year. However, we have seen plans as small as $500 to as big as $3000 per year coverages. In layman’s terms, that means that once your dental insurance company pays that amount, they will not cover it anymore. Dental Insurance is much different from medical insurance, car insurance, homeowners’ insurance, or any other insurance. It’s in a ballpark of its own, and we’re here to break it down for you.

Preventative Dental Insurance Coverage

Your dental insurance will most likely cover preventable services such as cleanings and exams. Insurance companies want you to keep up on preventative care as much as we do! Neglecting routine cleanings and exams costs you and your insurance provider big money! Each plan is different, but most dental insurances cover 100% of routine cleanings and exams (considered under the coverage type called Preventative). You will not pay any out of pocket for this in most cases. It may as well be free! (Except that you likely pay for this through your employer or individual plan). Moreover, preventive care is the most important thing for your oral health.

Dental Insurance Deductibles

You have probably heard of deductibles before. A deductible is what you pay for dental services out of pocket. Unlike medical insurance, your dental Deductible is usually smaller, and once you hit your Deductible, insurance will only pay up to your yearly maximum. Generally speaking, insurances do not require the Deductible to be paid to get preventative care. Again, FREE preventative! Paying the Deductible is usually for major or minor services such as crowns or fillings, respectively.

Types of Dental Insurances

Commercial Insurance

Commercial dental coverage is insurance through your employer. This is a benefit you pay for through your job. Sometimes your employer will pay towards your dental plan, too. Hale Family Dentistry is in-network with most local Fort Wayne companies’ dental insurances and nationwide carriers.

Medicare Insurance

Hale Family Dentistry is in-network with many Medicare plans. Traditional Medicare plans do not cover dental, but Medicare alternatives such as United Healthcare Advantage Plans or AARP plans have dental with varying coverage depending on the plan you choose.


We believe that dental care should be affordable and accessible to everyone. For this reason, we are in-network with many commercial and Medicare plans. We will submit dental claims to your insurance and help you navigate the insurance process.


When we are out of network, we can still provide care at our office for a reduced fee called “Usual & Customary” rates. Sometimes someone in-network and out-of-network coverages are the same! Our office and staff can help you navigate and understand your insurance if you’re out-of-network but still want to be a patient here.

Putting off dental treatment will cost you more in the long run and may cause future health risks!

  • Higher risk of developing an infection
  • Neglecting dental care leads to more tooth decay
  • Procedures that involve extractions stem from lack of preventative care
  • It’s a common phrase in dentistry that, “Dentistry isn’t expensive, neglect is.”

Hale Family Dentistry takes many dental insurance plans. Use our dental insurance tool to see if yours is on the list!

“Many dental insurance companies have switched to twice a year cleanings rather than the ‘every six-months frequency. Meaning, you don’t have to wait until exactly 6 months from your last cleaning if it doesn’t work for your schedule. Schedule earlier, by even a day, and it will still be covered. This is a change that we can get behind. *Be sure to check with your specific plan’s coverage.

Check to see if we are In-Network

Is dental insurance over your head? We offer a FREE benefits check. Or use our handy insurance checker tool right on our website to see if our Fort Wayne Dental Office can take your insurance.

We can look into your dental benefits and give you a complete breakdown of what is and is not covered. We also track this in our system for each of our patients. New and existing patients can call us anytime to learn more about their dental coverage at (260) 482-3759.

Being well-informed about your insurance coverage can help you make the most of it.  At Hale Family Dentistry, we pride ourselves on the ability to speak dental insurance fluently and help you understand it better. Never hesitate to ask us if you’re unsure!

No Dental Insurance? We can help!

Check out our Smile Membership if you don’t have dental coverage!

Our smile membership is a discount program we offer to patients without coverage to help keep costs down and help your mouth stay routinely clean! It’s essential to see the dentist every year, whether you have dental insurance or not. When you go for your regular check-up and cleaning, your dentist can look for any signs of trouble and address them early on – which is better for both your oral health and your wallet!

Call (260) 482-3759 to make an appointment today.


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