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How Much Do Most Dental Plans Cover?
Dental insurance is separate from your family’s health insurance and covers you from the high costs of dental care. You can get dental insurance either as an employee benefit or you can buy a plan. As per the National Association of Dental Plan, 77% of Americans have dental benefits either through private coverage, employee, or group programs.
But have you seen the fine print of your plan and know what all is covered or not covered in your plan? As we go through this article you will learn how dental insurance works, what it covers, and what is not part of your dental insurance plan.
How Do Dental Insurances Work?
Most dental plans work similarly as described below:
- You pay a monthly or yearly premium.
- Most plans offer free preventive care (annual exam, cleaning, x-rays, etc.) with zero cost incurred by you.
- Before coverage begins, you might have a waiting period of six to twelve months.
- You may have to select a primary dentist within the network of insurance providers.
- You might have to pay a certain amount out-of-pocket as part of deductibles before your insurance company covers a percentage of the out-of-pocket charges.
- There is a cap on annual allowance in most dental plans.
- You might have to copay each visit.
What is Covered in Dental Plans?
Most dental insurance plans cover preventive care like routine exams which is the basic coverage. There are also full coverage plans which, apart from preventive care, also cover a broader range of services that may include major procedures like dentures, crowns, dental implants, braces, aligners, surgical extractions, and orthodontic treatments (though they do not cover 100% of the costs)
In general full coverage works on a 100-80-50 cost-sharing model where:
- Preventive services such as teeth cleaning, routine check-ups every six months, etc. are covered 100%.
- 80% of the cost of some basic services like extractions, fillings, and root canals are covered by the insurance company.
- 50% of the cost of major services like crowns, implants, etc. are paid by a dental plan.
- In some plans, a portion of orthodontic appliances (for example retainer, braces, etc.) is also covered.
Dental insurance can cover preventive care completely and also pay a certain percentage of basic or major procedures. Cosmetic dental services (veneers, teeth whitening, etc.) which are not a medical necessity are not in general covered by any dental insurance plan.
If you are looking for Dental Billing Solutions in US, you can contact Capline Dental Services.