How Can I Get The Most Out Of My Dental Insurance?

If you’re paying a monthly premium for dental insurance, it’s only natural that you would want to make the most of the coverage you’re paying for. So in this blog from Carmel Valley Dental, we’ll take a look at a few tips and strategies you should follow to maximize your benefits. 

1. Find A Dentist In Your Insurance Network

Most dental plans are PPOs (preferred provider organizations). This means that you can go to any dentist you want, but your out-of-pocket costs will be lower if you see a dentist who is part of your PPO network.  

At Carmel Valley Dental, we’re in-network with most major providers in the area including Delta Dental, Aetna, Cigna, MetLife, Guardian, and Dental Health Alliance. Contact us for more information and to see if we accept your plan.

2. Make Use Of Your Covered Twice-Yearly Preventive Care Appointments 

Almost all dental plans cover two yearly oral exams and cleanings, and one yearly set of x-rays at no out-of-pocket cost. To make the most of your benefits, you should always make sure your family sees the dentist twice a year. 

Not only does this help you make the most of your plan, but you’ll also be able to keep a closer eye on your oral health and avoid potential problems like cavities and tooth decay. 

3. Know If Your Kids Have Additional Coverage Available 

Kids under 18 often qualify for additional preventive care, such as fluoride treatments and dental sealants. Check with your plan provider to see if your kids can qualify and get these treatments at no cost. Sealants and treatments are also available to adults, but are not usually covered fully by your insurance. 

4. Consider The 100-80-50 Rule 

This may vary, but most insurance policies have a “100-80-50” rule about how much they pay toward your care. This means that 100% of your preventive care, such as the teeth cleanings and oral exams mentioned above, will be covered.

However, only 80% of basic care and 50% of major dental services will be covered. Basic care includes things like fillings and root canals. Major care includes crown, bridges, and more. 

What this means is that the more serious your oral health issues are, the more you’ll pay out of pocket. That means preventive care and good at-home oral hygiene can save you lots of money.

5. Be Aware Of Your Deductible & Annual Maximum

All plans have a yearly deductible, which is how much you need to pay out-of-pocket before your full benefits kick in. This is usually set between $25 and $250, but can vary depending on your insurer.

A similar concept is the annual maximum, which is usually set at $1,000 to $2,000. This is the maximum amount your insurer will pay toward your care in a calendar year. Once you exceed it, you pay for the rest of your treatment out-of-pocket.

Contact Carmel Valley Dental To Schedule Your Next Appointment Today!

It’s a good idea to consult with your insurer to learn more about your policy before you schedule dental care. But at Carmel Valley Dental, Dr. Bancroft and our team are always accepting new patients, and we’d be happy to meet you! If you’re ready to get started, give us a call at (858) 755-3780 or contact us online to discuss your insurance coverage and schedule your appointment right away. 

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