Dental Insurance 101: What You Need to Know
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. There are many differences between the two. Read on, we will explain.
Types of Dental Coverages and Plans
Insurance coverages and plans vary widely based on your employer, the insurance company, and the provider to which you choose to go to. However, there are a few things most dental plans have in common.
– Maximum Yearly Benefit or Coverage Amount (AKA Your Yearly Max)
– Preventive Care Coverage
– Yearly Deductible ($0-$100)
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 pay 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 more for you.
Preventive Dental Insurance Coverage
Your dental insurance will most likely cover preventive services such as cleanings and exams. Insurance companies want you to keep up on preventive 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 preventive). 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 preventive care. Again, FREE preventive! 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.
In-Network
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.
Out-of-Network
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. We are in-network with many of the insurances listed here and more. If your insurance isn’t listed here, please call our office because sometimes insurances are branded under different names, but use an umbrella company such as Aetna or Cigna, with who we are in-network.
Insurances we currently take as of 2022-2023 – This is not a complete list*
Cigna – AARP Medicare & Advantage – Medicare Plans – Aetna – Delta Dental – UMR – Anthem – Signature Care – Principal – Lincoln United Healthcare – Fort Wayne Public & Private County School Systems – Fort Wayne School Corporation – Northeast Allen County School System – East Allen County School Systems – Southwest Allen County School Systems – Employee Plans – City of Fort Wayne Plans – Parkview Hospital Dental Insurance – Lutheran Hospital Dental Insurance – GEHA – Postal Service Insurance – UPS Dental Coverage
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.
Do you have dental benefits remaining for 2022?
Is dental insurance over your head? We have got you covered! Hale Family Dentistry offers a free benefits check. 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 plan is a discount program we offer to patients without dental insurance 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.