Posted by: Maplewood Dental Arts in Family Dentist

Dental Benefits and Your Dental Health

Sam at the front desk
  • Did you know that your dental plan is a contract between your employer and the insurance company… not with the dentist?
  • Do you know what your in and out-of-network benefits are?
  • Do you know if you have a waiting period before doing any major dental work or what your plan limitations are?
  • What is your annual maximum and does your plan roll any benefits into the next year if you don’t use them?
  • What does your insurance actually cost you and is it worth it based on your dental needs?

January is a great time to get all the information you need about your dental benefits for 2018! We recommend that all of our patients learn more about their specific plan by looking up the provider on the internet. Most dental plan providers have helpful information and frequently asked questions on their websites and even a patient portal that allows you to set up a profile and informs you about your unique plan.

Insurance is a contract between you, your employer and the insurance company. It is not an agreement, or contract, that you have with your dentist. While we make an effort to know about your insurance plan, there are 100s of different insurance policies accepted in our practice. It would be impossible for us to know everything about the features and benefits in every plan. We strongly encourage our patients to get to know their own plan and understand all the unique details of their coverage.

The coverage and benefits can vary widely from plan to plan. In fact, the primary intention of the dental benefit is to cover your annual preventative care which typically includes twice-yearly cleaning, dental exams, x rays and fluoride treatment for children. These are about the only services that most dental plans fully cover. Some plans might only pay 50% of the fee for a crown. Some plans pay on a set list of fees while others pay a percentage of a particular procedure. Some procedures are not covered at all due to your specific plan limitations. There are also a wide range of out of pocket deductibles that you may have to pay before you receive any benefits. There is also usually a maximum amount your insurance will pay for your dental health needs in a given year regardless of your need. Dental insurance policies have a lot of fine print where they can bury their rules and regulations!

You can also talk to your HR department at work to find out about the coverage provided in the plan they have negotiated with the insurance company. By knowing your plan and how it changes from year to year you will be able to maximize the dental benefits that you are paying for with your insurance premium. We also offer convenient and affordable financing options from Lending Club and Care Credit to help you with any out of pocket expense that might be necessary for your treatment plan with us. Once you are familiar with the details our team at Maplewood can help you plan the treatment you need and maximize the value of the dental benefits your insurance provides.

Samantha Standley, Clinical Manager, Maplewood Dental Arts