Dental Insurance Terminology

Here are some key points about dental insurance:

Dental insurance is a type of health insurance that covers a PORTION of the costs associated with dental care, including preventive, diagnostic, and restorative services.

It’s important to carefully review the terms and conditions of any dental insurance plan, considering factors like coverage, cost, network, and limitations. Additionally, individuals should be aware of waiting periods, exclusions, and any other policy-specific details. Regular dental check-ups and preventive care can contribute to oral health and may help reduce the need for more extensive and costly treatments. It is ultimately up to you to know your plan information.

At Staley Dental Arts, our team can help you interpret or understand any questions.

Insurance Terminology

Coverage Types:

• Preventive Care: Typically includes routine check-ups, cleanings, and X-rays.
• Basic Procedures: Covers fillings, extractions, and other basic dental procedures.
• Major Procedures: Addresses more complex treatments such as root canals, crowns, bridges, and orthodontics.

Deductibles and Copayments:

• Deductible: The amount you MUST pay out of pocket before the insurance plan begins covering costs.
• Copayment: A fixed amount you pay for a covered service, with the insurance covering the rest. Most dental offices will give you an estimate.

Networks:

• Dental insurance plans often have a network of dentists, and visiting an in-network provider may result in lower out-of-pocket costs.

Annual Maximums:

• Many dental insurance plans have annual maximums, which cap the amount the insurance will pay for covered services within a year.

Waiting Periods:

• Some plans may have waiting periods before certain services are covered. For example, major procedures may have a waiting period.

Exclusions:

• Certain procedures or conditions may be excluded from coverage, so it’s essential to review the policy details.

Premiums:

• The amount you pay for dental insurance, typically on a monthly basis.

Employer-Sponsored vs. Individual Plans:

• Dental insurance may be provided through an employer as part of a benefits package, or individuals can purchase plans independently.

Orthodontic Coverage:

• Orthodontic treatments, such as braces, are often covered but may have specific limitations.

Cosmetic Dentistry:

• Cosmetic procedures, like teeth whitening, are often considered elective and may not be covered.

Pre-existing Conditions:

• Some plans may have limitations on coverage for pre-existing dental conditions.

Our team can help you interpret or understand any questions you may have about Insurance Coverage options and details.