Dental Insurance Coverage
We’re always happy to hear that our patients have dental insurance; it can play an essential role in making dentistry affordable for every member of your household. Here at Family Dentistry of Sioux Falls, our team has extensive knowledge of how insurance works, and we have years of experiencing in filing claims. We often work with complex benefit plans, and we’re happy to help you understand your coverage and get the most out of it. Our goal is always to help you maximize your benefits and minimize your stress!
Give us a call if you ever have questions about your dental insurance or treatment plan, or if you need assistance with anything that relates to your oral health. Whenever you need us, we’re eager to lend a helping hand.
Dental Insurance Basics
One of the keys to understanding your coverage is to grasp the meaning the terms that occupy your policy’s fine print. Here is a brief breakdown of some basic aspects of dental insurance:
- Premium – The amount that you and/or your employer pay to your dental insurance company. Most plans require monthly premium payments.
- Maximum – The highest amount that your policy will pay out for treatment within a year.
- Covered cost – The percentage of total treatment cost that your insurance will pay.
- Out of pocket cost – The percentage of the total treatment cost that you must pay.
- Deductible – The amount that you must pay for treatment before your dental insurance kicks in. Not all plans require a deductible.
Understanding Your Dental Benefit Plan
Dental insurance can be complicated sometimes, and plans vary from person to person and from employer to employer. However, the basics remain the same. You keep up with your premium in order to offset the cost of your dental treatment and keep your insurance plan active. As long as you remain in good standing with your benefits provider, you can expect them to cover your dental care at (roughly) the following percentages:
- Preventive dentistry – 80% to 100%
- Restorative dentistry – 50% to 80%
- Orthodontics – 50% to 80%
- Dental implants – Traditionally, dental insurance companies offered no help with implants, but this is changing. Check out your policy to discover if it covers dental implants.
- Cosmetic dentistry – Dental insurance does not typically cover cosmetic procedures.
Maximizing Your Dental Insurance
The key to maximizing your dental insurance is keeping up with routine dental checkups. During these biannual appointments, we’ll check for any budding oral health concerns, and we’ll likely be able to stop them before they turn into major problems. If there are some issues we can’t prevent, we’ll design a conservative treatment plan to get your smile’s well-being back on track.
Since most insurance companies completely cover the cost of preventive dental care, you may be able to maintain a healthy set of teeth and gums for little more than the cost of your premium.
In-Network VS Out of Network Dental Insurance Coverage
We’re proud to be in-network with several major insurance companies. This means that we have pre-negotiated rates with these benefits providers, thereby providing savings to both the insurance companies and their clients (you). However, even if we are not in your plan’s network, we’re still willing to file claims for you and work with your insurance company to help you get the most out of your benefits.
When you give us your insurance information, we’ll look into your benefits and estimate the portion of your treatment that your plan will cover. We’ll frankly discuss the cost of your treatment with you so you understand your financial obligation.
No Insurance? No Problem?
Dental care is vital for everyone, regardless of if you have insurance. That’s why we work with CareCredit and Lending Club to provide affordable financing options for our patients. We’re happy to help you apply for these options so you can pay for your treatment over time.