Unraveling the Mysteries of Dental Insurance and How it Affects You as a Patient

A Patient's Guide to Understanding Dental Insurance for Some of the Most Popular Dental Procedures

When it comes to dental insurance, many people are confused understanding the technical terms and specifications that define what is, and is not, covered for patients seeking treatment at their dental offices. While individual plans vary, all have common technical terms and plan  limitations that, when understood, help budget treatment options for patients in need of treatment. Let's take a look at some of the most popular features of dental insurance plans.

Yearly maximum benefits - This is the amount of charges that your insurance company will pay. The charges are for approved services that meaningful and necessary for a patient's dental care. Most plans have an annual maximum of $1200, but this means $1200 maximum after the patient has paid their portion. A good example of this would be a root canal procedure which requires a crown. If you are told that the total cost will come to $2000 and your deductible requires a 50% cost share, you would pay the dentist $1000 and your insurance company would be billed the other $1000. This would still leave you $200 of your annual benefits left for additional procedures. If you, the patient, are unsure if a procedure is covered or not, ask your dentist to submit a predetermination before you have your procedure performed. The insurance company will outline the amount of money they will cover (allowable amount per procedure), as well as, your cost (patient share).


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