Between celebrating the holidays and wrapping up loose ends from the year, the last few months of the year are a busy time for everyone. And while you might not be thinking about your dental insurance, but you probably should be! Unfortunately, many people wind up losing their benefits by not scheduling with a dentist in Fox Chapel. In fact, a recent study by the American Dental Association found that the average annual benefit is $1,250 per person, but most people only get around $323 of dental work annually. That’s over $900 in benefits that many people are passing up! Keep reading below to find out what’s usually covered and get tips on how to take advantage of your benefits.
What Will Your Insurance Cover?
When it comes to insurance coverage there are countless different plans, so it’s always a good idea to start by checking your specific benefits. Having said that, here are some average coverage percentages for many common procedures:
- Cleanings, X-Rays and Exams – Your checkups are preventative, so they’re often covered at 100%. Many patients get 2 checkups a year, although more may be covered during pregnancy or for patients who have gum disease, diabetes or cancer. Also, professional fluoride treatments are a wonderful way to prevent cavities and may also be covered.
- Deep Cleanings – Deep cleanings are a more involved type of cleaning for patients with gum disease. They’re usually covered at 60%-80%.
- Fillings and Root Canals – Fillings and root canals are also typically covered at 60%-80%.
- Crowns and Bridges – Many plans will cover crown and bridgework at 50% – 70%.
How Can You Maximize Your Insurance Benefits?
Your first step is to double check when your plan year starts and ends. Most plans start January 1st and end December 31st, but in some cases, they’re on a fiscal calendar year.
Also, dental schedules tend to fill up quickly, so schedule any appointments as soon as possible. At the very least, makes sure everyone in the family has gotten their checkups since they’re usually covered at 100% and won’t cost you anything out of pocket.
If you need more involved dental work, you can ask your family dentist in Fox Chapel to file a preauthorization beforehand, which is a breakdown of the coverage your insurance company will provide and an estimate of your total cost.
Finally, don’t forget that each insurance plan has an annual maximum, which is the total amount they’ll pay for each person (usually $1,000-$3,000). You may as well use this money to help you achieve great oral health and a beautiful smile – at a greatly reduced cost to you!
About the Author
Dr. Ray Voller is a family dentist in Fox Chapel who wants to help every patient maximize their insurance so they can get the dental care they need. That’s why he and his staff are always available to help their patients navigate their plans. If you have any additional questions about your insurance, he can be reached via his website or at (412) 406-8100.