Dental insurance plans vary from company to company, and the breakdown of the coverage is often difficult to understand. As a result, many patients have a hard time determining what, precisely, is covered by their insurance. A dentist in Lake Zurich is here to provide a brief overview of what dental insurance coverage typically looks like.
What Does Dental Insurance Normally Cover?
The services covered by dental insurance usually fall into one of two categories: preventive and restorative. Most policies will pay 100% of the cost of preventive services such as routine examinations, cleanings, fluoride treatments, and at least one set of X-rays a year. The idea is that providing more coverage for preventive care encourages patients to visit the dentist and potentially avoid larger oral health issues.
When it comes to restorative care, coverage tends to vary. Minor restorative services such as fillings usually receive around 80% coverage, whereas major treatments like tooth extractions typically receive 50% coverage. Some services, such as dental crowns, could be considered minor or major depending on the policy.
The amount that the insurance provider pays for any given treatment depends on various factors. For example, most plans have an annual maximum that determines how much money they will spend on the patient’s dental care over the course of one year. If there are not enough funds left over, the insurance may pay less than what they normally would. Thus, patients need to be mindful of their benefits and how much of the annual maximum is remaining.
What Is Not Normally Covered by Dental Insurance?
The majority of dental plans will not pay for cosmetic services that are only meant to improve the appearance of the patient’s smile. This is because cosmetic treatments are elective, as opposed to preventive and restorative care that is necessary for optimal oral health. Dental insurance will not typically cover services that are normally elective, although there may be exceptions if said services do provide some sort of health benefit.
Patients who are interested in cosmetic dentistry will likely need to pay for such services out of pocket. Those who are unable to cover the entire cost upfront may want to consider applying for a financing plan that lets them pay in monthly installments instead. Another option is to find a practice with an in-house membership plan that offers discounts on cosmetic treatments.
The post above only provides a general outline of what dental insurance coverage might look like. Patients who are still confused about the particulars of their specific plan should speak to a member of their dental team. Most dental practices have insurance experts who can clearly explain which services are covered by insurance, thereby helping patients maximize their benefits.
About the Practice
At Grand Dental – Lake Zurich, we have two general dentists, an orthodontist, and a periodontist under a single roof. Having multiple experts in one place allows us to provide our patients with truly comprehensive oral health care. We gladly accept multiple insurance plans and are happy to help you get the most out of your coverage. To schedule an appointment with us, visit our website or call (847) 438-8136.