Maximizing Your Dental Insurance Benefits

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Updated: 29 July 2024
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Insuranceopedia Staff
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In the United States, standard health insurance usually doesn’t cover dental services. Many people buy dental insurance separately, while some get it through their employers. However, not everyone knows how to get the most out of their dental insurance. Here’s some helpful advice on maximizing those benefits.

Understanding Your Insurance Company’s Goals

Dental insurance plans are designed to save the insurance company money in the long run. They often prioritize preventive care because it’s cheaper to prevent problems than to fix them later. That’s why they usually cover 100% of preventive services like checkups, cleanings, and X-rays. They may also cover other preventive treatments like sealing teeth fissures to prevent decay.

It’s essential not to overlook preventive care opportunities. Insurance often covers dental fillings at 80-100%, but more complex procedures may only be covered at 50%. So, it’s crucial not to postpone seeing a dentist wherever you are, whether it’s seeing a dentist in Forest Hills, NYC, or elsewhere in the United States.

Understanding Deductibles

Deductibles are required for dental treatments but not for preventive procedures, which are fully covered by insurance. The deductible is a separate payment due once a year. If you only get preventive care one year and need treatment the next, you won’t pay the deductible in the second year. However, if treatment spans two years, you’ll pay the deductible twice.

Health Savings Account (HSA) Options

An HSA isn’t insurance, but many employers offer it as a benefit. With an HSA, you can deposit money tax-free for medical and dental expenses, providing a way to save on healthcare costs. When using an HSA, it’s crucial to keep records of expenditures and ensure the funds are used before they expire.

Choosing the Right Insurance Plan

Having multiple insurance plans doesn’t necessarily mean everything will be covered. During a claim, one insurer is designated as primary, and the other is secondary. The primary insurer is first responsible for payment, but the patient still covers deductibles and co-payments. It’s important to choose an insurance plan based on coverage needs, not just low premiums.

When choosing a plan, consider whether your employer provides dental coverage and anticipate any potential treatment needs. Don’t solely focus on low premiums, as they may only cover specific procedures. Gathering information directly from a dentist can help you make an informed decision and find ways to save on dental costs.

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