Dental Insurance: The Ins and Outs
Our goal is to provide you with high quality patient care in a team building relationship while delivering the best oral health care possible to our patients. Since dental insurance is offered in a variety of packages, we thought you might benefit from answers to questions we frequently hear.
What do I receive for services at your office?
- Our office offers preventative services, such as cleanings and digital x-rays. We also offer more extensive services like fillings, crowns and bridges, implants, and dentures.
How do I obtain dental insurance?
- While dental insurance for some is an employee benefit, for others it may be an individually purchased dental plan.
- Benefits are determined based on the coverage purchased, by either the employer or employee.
- Most dental plans follow what is known as the 100%, 80%, 50% model that corresponds to three types of procedures. Please keep in mind that the following are general rules and that each policy could be different.
Type 1 Diagnostic/Preventative – routine dental cleanings, exams, x-rays, oral cancer screenings, sealants, and fluoride treatments. Many dental insurance plans cover close to 100% of costs associated with Type 1 procedures.
Type 2 Basic/Restorative – composite restorations (white fillings), root canals, extractions, periodontal cleanings, and periodontal root debridements (treating periodontal disease). Many dental insurance plans cover close to 80% of costs associated with Type 2 procedures.
Type 3 Major – crowns, crown buildups, bridges, implant crowns, and dentures. Many dental insurance plans cover close to 50% of costs associated with Type 3 procedures.
What does my plan cover?
- It’s important to check your individual dental coverage before having dental services rendered. Many dental insurance companies have exclusions, waiting periods, and annual or bi-annual dental maximums along with varying deductibles and co-pays.
Do I have dental insurance benefits left for this year?
- Ask our front office team to assist you in finding out what your remaining individual benefits are.
Will I lose those benefits if I don’t utilize them?
- Yes and no. With some plans, you will lose your dental benefits if you don’t use them by year end while other plans have a small rollover feature. We can help you find the specifics for your policy.
If you still have questions related to dental insurance, please give us a call at 207-781-5900 and our office staff will assist you in any way we can.