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3 Helpful Tips for Understanding Your Dental Insurance

September 24, 2020

Filed under: Uncategorized — drsaran @ 10:15 pm
Graph of paperwork, tooth, and calculator

Your biannual visits to the dentist play a crucial role in your oral health. However, the examination alone can range between $50 and $300, and that doesn’t include the cleaning, fluoride treatment, or X-rays. So, those routine visits can quickly add up. Fortunately, that’s where dental insurance comes in! To help you understand your coverage, a dentist in Long Island City is sharing three tips!

#1. Learn Common Terminology

  • Benefit period – Essentially, your benefit period is the length of time between your “effective date” and “end date.” If you do not renew your plan before your end date, then you will no longer have coverage.
  • Deductible – Like your auto insurance, most dental plans have a deductible, which is the amount you pay out of pocket before your insurance company pays for any treatment. Typically, preventive services, like checkups and cleanings, do not have one.
  • Maximum – Your coverage will outline both an annual and lifetime maximum. This refers to the amount your dental insurance company will pay during your benefit period and the dollar amount they will ever pay.
  • Waiting period – Some plans have a waiting period for certain treatments, which delays coverage on certain services until a specific date. For example, if you have a three month waiting period for root canals, then your coverage for that procedure won’t kick in until three months after your effective date.

#2. Understand “100-80-50” Coverage

Since dental insurance is centered around preventive care, you may see the sequence “100-80-50” written across your paperwork repeatedly. This simply refers to the coverage you have based on the three common services patients receive. 100% of preventive care is covered, 80% of basic procedures, and 50% of major treatments.

#3. Get Familiar with Your Plan

Biannual visits are fairly easy to plan for, but painful toothaches and dental injuries can happen at a moment’s notice. To save yourself the headache (and help you quickly get the treatment you need!), take the time to get familiar with your plan beforehand. If you run into unfamiliar jargon or are unsure what services are covered on your plan, don’t hesitate to talk to your provider or your dental team. They both deal with dental insurance on a daily basis and are happy to help you understand your coverage.

Deciphering the unfamiliar jargon on your dental insurance can be overwhelming. Fortunately, you can use the above tips to thoroughly understand your coverage!

About the Author

Dr. Ishwinder Saran completed his Doctor of Dental Medicine at one of the top dental schools in the nation, Boston University Goldman School of Dental Medicine. Since then, he has helped his patients achieve pristine oral health, completed advanced training at Spear Education, and maintained an active membership at reputable organizations like the American Dental Association. If you are looking for a dentist in Long Island City, don’t hesitate to visit his website or give him a call at 718-530-6539.

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