An Inside Look At Dental Insurance Benefits (& How To Maximize Yours!)

By Author: Zach Kingsberg
Total Articles: 55
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In short, having dental insurance and using dental insurance are two different things. In fact, many insured patients unintentionally leave hundreds or thousands of valuable dollars on the table each year because they aren’t sure how to utilize their coverage to the fullest. Fortunately, there are a few easy ways to prevent that from happening to you. With this in mind, keep reading to learn a bit more about how dental insurance benefits work and how to maximize yours!
The 100-80-50 Structure
Although dental plans vary from one patient to the next, many have the 100-80-50 benefits structure. Here’s a simplified version of this coverage:
• 100% of the cost of preventive care, like checkups and cleanings
• 80% of the cost of basic procedures, such as dental fillings
• 50% of the cost of dental crowns, bridges, and other more extensive treatments
Be Mindful of Factors like Annual Maximums and Waiting Periods
As mentioned above, the fine print on your dental plan will factor into how you can use your specific ...
... benefits. For example, if you have a waiting period for root canal therapy, then you will have to wait the allotted amount of time before you can use your benefits for that treatment.
Another important factor is your annual maximum. This is the highest dollar amount your provider will contribute to your care. It’s important to be aware of this number so you can do your best to avoid paying for your entire treatment out-of-pocket.
Remember: Many Dental Plans Reset at the End of the Year
While some plans renew a year from when you sign up, many renew at the end of the year. So, when the clock strikes midnight on January 1st, any unused benefits will go to waste. That’s why it’s so important to schedule your dental care with that in mind. One of the best things to do is schedule your first checkup in January or February and your second one in July or August. That way, you always use your preventive care coverage and any restorative work you need can be conducted well before the end of the year.