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What Does Dental Insurance Cover

Dental insurance can cover a variety of things depending on the plan chosen. The amount that a policy covers usually depends on the insurance company. A policy with a lower premium is going to come with less coverage and/or higher deductibles, and a policy with a higher premium is going to come with more coverage and/or lower deductibles. A common type of coverage in a dental plan is 100-80-50 which indicates the percentage covered depending on the level of care. Some policies do not follow this trend. The policy that is going to fit your needs is the most successful.

Diagnostic & Preventive

When it comes to a preventive care, most dental plans cover either all or most of the cost and usually do not include a deductible. Preventive care consists of exams and routine cleanings; these treatments can help stop issues from either arising or progressing. Most often the plans that people have follow the 100-80-50 coverage. The 100 is 100% coverage on preventive care and routine checkups. Not all plans follow this layout. A discount dental plan works a bit differently because a customer receives a discount card. This discount card provides a percentage off or a different rate that isn't as great of a discount as a traditional plan, but it is cheaper than going to the dentist with nothing. Insurance companies see the benefit of investing in preventive care as it prompts their customers to go to the dentist every 6 months which in turn gives the company healthier customers.

Minor (Basic) Procedures

Minor treatments include procedures such as fillings and teeth extraction. On this level, there will most likely be a deductible that needs to be met before the insurance will pick up the coverage. For those with a traditional dental plan, it may differ in the amount of coverage and deductibles that need to be met, but will relatively be the same. Some form of coverage on basic, or minor, procedures will still be provided. For a discount dental plan, there will be a discounted rate off the retail price and the rest will be out of pocket. Normally, it is a lower percentage off than with the traditional plans, but there is no deductible with discount plans.

Major Procedures

The next level of coverage is major procedures, and these include crowns and bridges. This level of care is the most expensive. Most likely, there is a deductible that will need to be met, and then commonly a percentage of coverage will be applied. A discount plan will most likely still give you some sort of discounted rate, but it will mostly be out of pocket when it comes to these bigger procedures.

Orthodontia (Ortho)

Orthodontia is a procedure that has become more popular as people have seen the benefits of having straight teeth such as the improvement to the health of the teeth when they are in the proper positions. However, not all plans cover this. If either you or someone in your family will need braces, look for a plan that has specific orthodontia coverage otherwise the whole thing will be out of pocket. As for the amount of coverage, it is going to be dependent on the individual plan and how extensive the treatment is going to be. Normally the dentist will create an estimate of the total price of everything which will be sent over to the insurance, and then the amount covered and out-of-pocket expense will be communicated.

Implants

Implants are a procedure within the level of major procedures that are not always covered. This is because a bridge can often replace a missing tooth for a cheaper price, so insurance companies are willing to cover the cheaper option. Implants are viewed as more of a cosmetic procedure and not a medical procedure because implants look more like natural teeth than a bridge. Another thing to note is that if you already have pre-existing conditions that require implants to recover the health of your teeth, but try to get a plan that includes implant coverage, you may be denied coverage. When it comes to implants, look around to see how much a plan will cover and if you are eligible for that coverage.

Veneers

Veneers are not usually covered by dental insurance due to big cosmetic influence and lack of actual need for them. If receiving veneers are crucial to your dental health, your dentist will need to submit an estimate along with the reason for these to be sent to your insurance to be reviewed for pre-determination to see what they will cover if anything. A crown is more likely to be covered. They will last longer and solve the medical issue as well. Veneers are often requested for aesthetic reasons which is why even though crowns and veneers are extremely expensive procedures, a dental insurance company will cover crowns over veneers.

Read Plans Carefully

Much of what is covered by a dental plan is all dependent upon what plan is chosen. Generally, a policy will cover more of the cost of preventive treatments than the costs of larger more involved procedures. There are different plans to fit with individual needs and circumstances. When shopping around for a dental plan, pay attention to coverage and premiums to decide which is the best dental insurance for you.