Dental insurance is a helpful benefit to assist with payment for dental treatment. A dental insurance plan is usually provided by an employer as an additional group option (rider) with a medical insurance benefits package. Dental insurance premiums vary, the subscriber may pay $0-100 per month depending on the overall insurance benefits package and the coverage level provided.
Nearly all dental insurance plans are structured to only pay a portion of treatment costs; for example, fillings may be covered at 50% of the benefit allowed by the insurance carrier. Preventive care, such as dental cleanings and x-rays, is often covered at a higher rate, 90-100% of the insurance carrier's allowed benefit.
Dental insurance does not cover teeth whitening and rarely covers elective cosmetic procedures (such as dental veneers).
Dental insurance benefit allowances are determined by the insurance carrier based on a number of factors such as the number of subscribers, premiums and other data. They do not necessarily align with dental office fees.
- Dental insurance plans have ‘maximum’ annual payment caps, i.e., $1,000-$2,000 in benefit payments per year towards covered services. After the allowance is depleted, the insurance company will not reimburse dental services until the next year.
- Many carriers have exclusions, such as a ‘missing tooth clause’ that does not reimburse for replacement of missing teeth with a bridge, dental implant or denture; usually this is for the first 12 months of the plan.
- The majority of dental insurance plans have frequency limitations, such as one cleaning every 6 months, or x-rays once per year.
At Magnolia Dental Spa of Athens, getting the most benefit from your dental insurance plan is important to us too. We know that you worked hard for those insurance dollars, and we want to help you put them to good use.
Most dental insurance companies do not determine payment until after treatment is performed. Our administrative team will work with you and your carrier to obtain an estimate of reimbursement to help you with planning your care.
The first step in understanding your dental insurance plan is to ask us to contact your insurance company to get a detailed breakdown of benefits, limitations, exclusions and coverage percentages. With this information, we can help to decipher how your plan works with your treatment needs.
If this all seems confusing, we can help! Please call Magnolia Dental Spa of Athens 706.607.9772 and share your insurance details with us. We will be happy to research your coverage and get a breakdown of benefits to help you understand your policy.