Dental benefits can be confusing. A lot of patients don’t get the full use out of them each year, even though many dental insurance plans cover a lot of things. Here is some helpful information about dental insurance plans that will help you keep your teeth strong this year.
How Dental Insurance Works
Dental insurance works a bit differently than many types of insurance. While your homeowner’s insurance might help you pay for repairs if your home suffered a fire, dental insurance doesn’t “make you whole.” Instead, it helps pay for the regular cost of dental care.
Things to Know about Your Dental Insurance
- Regular Cleanings – Many dental plans pay the entire cost of your dental checkups twice per year. Some plans will even cover three or four checkups each year. Take advantage! Find out now what your plan covers and make appointments to see your Holly Springs dentist.
- Network – Check to make sure you choose a dentist that’s in your network. If you have an HMO, it’s required. If you have a PPO plan, your costs are much lower. For example, Klooster Family Dentistry works with these insurance plans. If you’re unsure about it, please feel free to call and ask us for help.
- Flexible Spending Accounts – If you have an FSA, you can use that money to pay for dental work. One important thing with these accounts is to find out if the money rolls over into the new year. Right now, you may have money rolled over from last year, but many accounts start over each time. That means it may be best to wait a few months until money has accumulated before scheduling more expensive health, eye, or dental procedures.
- Payments – Each month, you pay your insurance bill, called the premium. During your dental visit, you may be asked to pay a co-pay, which is considered your part of the cost of that checkup or visit. Once that’s done, some dentists will bill your insurance company first and then send you a bill for the remainder. Other dentists will ask you to pay and let your insurance company send you the check instead. Check with your dentist’s team to find out how it works.
- Insurance Terms – The jargon used by insurance industry is often the most confusing thing for people. The American Dental Association has a useful list of common terms and definitions.
- Annual Limitations – Some dental plans limit your total amount of coverage for the year. Be sure to check on this if you expect to have a lot of dental work done.
How to Choose Insurance
If you do not have dental insurance yet, be sure to enroll as soon as you can with your employer or with the Affordable Care Act (ACA) Marketplace. Dental coverage is required for children under the age of 19, but it is not required by law for adults and therefore you will not be penalized for not carrying dental coverage. However, dental insurance typically pays for itself each year due to the regular costs of X-rays, cleanings, and fillings. We offer more information about that and types of insurance plans in How to Maximize Your Dental Insurance Benefits.