So you’re trying to figure out your dental insurance benefits. You do your diligence, but after a while of reading dry, confusing insurance jargon, you’re just more confused. Why do your dental insurance benefits sound so different from your medical insurance benefits? Does the distinction matter? And, most importantly, how are you supposed to maximize your dental insurance benefits?
If your head is spinning, worry not! Here’s what you need to know about the difference between dental and medical insurance and how it affects you.
Dental and Medical Insurance Schools of Thought
It’s true that your dental and medical insurance have very dissimilar coverage philosophies. Medical insurance aims to blunt the cost of sudden and urgent injuries and illnesses. Dental insurance encourages patients to invest in preventative care, so both they and their clients spend less money trying to fix dental complications down the road.
Since so many dental problems often result from poor oral hygiene, this actually makes some sense. Biannual checkups and cleanings significantly reduce your risk for infections, tooth decay, and gum disease. Every dental insurance plan is unique, but in general that’s why the breakdown looks something like this:
- 80% – 100% of checkups and cleanings covered
- 50% – 80% of restoration treatments covered
- 50% or less of major treatments covered
Basically, it’s a good idea to take advantage of the way your dental insurance coverage works by always attending your biannual checkups!
Is It Really Worth It to Have Both Medical and Dental Insurance?
Everyone wants medical insurance. But is dental insurance worth it? How often are you really going to use it?
Dental insurance is definitely worth the price. Most premiums cost less than $100 per month, and in Texas, the average is about $29 per month. Given that a routine checkup and cleaning can cost up to $200 (without factoring in X-rays), that’s an incredible value! Not only will you pay minimal prices to have your dentist clean and examine your pearly whites, but you’ll also likely have some added financial assistance if you do need other treatments.
How Can I Get the Most Out of Dental Insurance Benefits?
That said, you’ll have to plan carefully if you want to take full advantage of your dental insurance benefits. Unlike your medical insurance, dental insurance typically has an annual maximum. This is essentially a cap on how much your provider is willing to pay out per year. That probably sounds complicated, but it just means that if you’re planning on getting multiple dental treatments, you’ll want to consider spacing them out.
Pressing pause and waiting until your maximum refreshes could save you money. However, keep in mind that postponing dental care can sometimes cause serious problems, so be sure to work with your dentist about your timeline.
Even if you know some dental insurance basics, it can still be difficult to use it effectively, especially when you start relying on the specifics of your unique plan. Fortunately, your dental team handles dental insurance every day! They can help you find the best way to use your benefits. Don’t be afraid to ask them for help with deciphering the details of your dental insurance plan!
About the Author
Dr. Steve Cha practices at Lake Forest Dental in McKinney. His favorite part of the job is interacting with patients. Thanks to his warm and welcoming demeanor, you can feel comfortable discussing how your dental insurance benefits can help you pay for your treatment! If you have questions about your plan, call 972-529-1800 to contact his office. For more information, explore his website.