Making Dental Care More Affordable
It always puts a smile on our face when we learn that our patients have dental insurance; it is a valuable provision that can keep your teeth in good shape while sparing you from excessive financial stress. If you are fortunate enough to have coverage through your employer, we strongly encourage you to make the most of it! Our experienced team is eager to help you do so. Whether you are coming in for a routine cleaning or more extensive work, we can help you understand how your benefits apply and how you can keep your out of pocket costs to a minimum.
How Dental Insurance Works
Most plans that your dentist in Plano works with cover preventive care at 100 percent. Yes, you may be able to visit your dentist for a routine cleaning and checkup twice a year for nothing more than the cost of your monthly premium! Other dental services are often covered at the following rates:
- Minor restorative care: 70% – 80% covered
- Major restorative care: around 50% covered
- Cosmetic work: Typically not covered
Some plans also include a deductible (the amount you must pay for services before coverage kicks in) and a yearly maximum (the maximum amount that your insurance company will pay out in a calendar year).
Dental and Medical Insurance – Understanding the Differences
The main focus of dental insurance is preventive care; it covers many non-emergency dental treatments, such as cleanings, fillings, X-rays, and much more. Medical insurance, on the other hand, has a more limited scope when it comes to caring for your mouth. It may only cover emergency procedures, such as treatment for an abscess or a serious jaw injury. In some cases, medical insurance may even play a role in helping you to pay for dental implants.
If you ever have questions about whether you should use your medical or dental insurance in a particular situation, don’t hesitate to ask us! We’ll examine the fine print of your policies and help you understand how each one may apply.
In-Network vs Out of Network
Whether our practice is in-network or out of network with your insurance provider, we’ll be happy to help you navigate your coverage, maximize your benefits, and even file claims on your behalf.
In-Network
If a dentist is in-network with a particular insurance company, it means that they have pre-negotiated the rates for certain services. This contract helps to save money for both the coverage provider and its clients. We’re proud to be in-network with many insurance plans, including:
- Aetna
- Ameriplan
- Ameritas
- AssurantDHA
- Cigna
- Comp Benefits
- Delta Dental
- DenteMax
- Dentegra
- GENA
- Guardian
- Humana
- Principal
- Unicare
- United Concordia
- United Healthcare
- Delta Dental – Premier plan
- Careington plan
- MetLife
Out of Network
Even if we are out of your plan’s network, that doesn’t mean you can’t come to us for top-notch dental care in Plano! PPO dental insurance plans allow their clients to visit any dentist, regardless of the dentist’s network status. We’ll still be able to help you file claims and enjoy a healthy smile that doesn’t break your budget.
Dental Insurance FAQs
Is Dental Insurance Really Worth the Cost?
Dental insurance is a wise investment for everyone. Even the most basic dental insurance plan will likely enable you to receive essential preventive care at little to no out of pocket cost. If you use your dental insurance only twice a year for your routine appointments, you’ll be saving money. Plus, your policy will be there to help you out in case you ever need to have any restorative work done on your smile.
It’s worth taking the time to shop around a bit for your dental insurance if you choose to purchase it on your own rather than through your employer. Policies vary greatly between insurance companies and even between individual plans, so comparing your options can help you to ensure that the policy you purchase offers the best value for you and your unique dental needs.
Does My Deductible Apply if I’m Just Receiving Preventive Care?
For most dental insurance plans, the deductible does not apply to basic preventive care, such as cleanings, routine exams, and routine X-rays. However, you should check the specifics of your policy just to make sure.
What if I Need a Major Treatment and My Dental Insurance Won’t Cover It?
There are a few major types of dental treatment, such as orthodontics and dental implants, that dental insurance doesn’t always provide coverage for. However, it may pay for part of such procedures. For example, it may cover dental implant restorations even if it doesn’t cover the implants themselves. We’ll help you understand how your policy applies in specific situations. We’ll also help you explore financing options that will bridge the gap between what your insurance will pay and what you can afford to pay at the time of your treatment.
How Can I Make Sure My Insurance Claims Go as Smoothly as Possible?
One way to insurance-related headaches is to visit a practice that has experience in dealing with the ins and outs of dental insurance. As your dentist who accepts dental insurance in Plano, Dr. Bhalla and our team have experience working with most types of policies from most providers, including Medicaid. We’re also in-network with a number of major insurance companies, including Humana, Delta, and Aetna.
To help us make sure your insurance claim goes through without a hitch, it would be much appreciated if you contact us prior to your appointment to give us your policy information. That way, we can confirm your coverage and prepare to help you get the most out of it when you visit our team for treatment.