It is recommended that on average most individuals visit their dentist about twice a year for professional teeth cleanings, but many Americans can end up going more often than that if they are experiencing tooth pain or discomfort in between those appointments. Even when in extreme pain, one of the biggest factors in an individual actually going to the dentist can be dental insurance.
For people requiring dental work, the most common dental insurance questions include:
- Does the dentist accept my dental insurance?
- Will it cover the cost of a regular cleaning?
- Do I have to pay up front and then get reimbursed by my insurance or vice versa?
- Is it cost effective to have dental insurance?
While every dental insurance plan is different, there tend to be some commonalities regarding what dental insurance covers, the benefits of having it, and how to find out if a dentist accepts your dental insurance.
What Types of Things Dental Insurance May Cover
Dental insurance is designed to cover at least part of the expenses related to dental procedures. These procedures generally fall into one of three categories:
1. Preventative care
This type of care is generally covered to a greater degree than other categories because as the name says, it is preventative and may help avoid future procedures. Procedures that commonly fall under this category can include x-rays, regular teeth cleanings, and dental exams. Each of these practices is designed to help identify issues proactively. X-rays are typically done once a year unless there is additional cause for concern, and teeth cleanings and dental exams are recommended every six months.
2. Basic care
This category isn’t typically covered to the degree that preventative care usually is, but it is still typically covered at least in part by dental insurance. Common basic dental care procedures often include having teeth extracted and getting fillings for cavities.
3. Advanced dental procedures
This last category is typically the most expensive for patients when it comes to dental treatments and can include complex practices such as crowns, root canals, implants, and bridges. It is possible for these treatments to take two or more visits for total completion, and some components required may have to be specially customized at a lab.
Benefits of Having Dental Insurance
Regardless of if it is routine x-rays or a more complicated situation such as a crown or root canal, some dental procedures can get expensive quickly due to the labor involved, as well as the cost of materials and use of specialized machinery.
An individual with dental insurance generally receives at least some kind of financial assistance with required dental treatments. With that said, most patients can still expect to pay some of the expenses beyond their general co-pay out of pocket.
How effective a dental insurance plan is can depend on a number of different factors, including:
- Average co-pays
- Cost of annual premiums
How to Find Out If A Dentist Accepts Your Insurance
Under the lens of dental insurance there are two primary types of dentists:
- Network Dentists
- Non-Network Dentists
Network dentists are those professionals typically included on a patient’s dental insurance plan. Depending on the insurance plan, it may be more cost effective for some patients to go to a dentist that is in network rather than out of network.
Non-network dentists are typically not singled out as approved providers by a dental insurance plan. This generally means that the dentist is picked based on a patient’s preference rather than being recommended by insurance. It is worth mentioning that these dentists still accept insurance, however, the out of pocket expense will differ.
To find out if a dentist accepts your insurance, it can be best to:
Start by reviewing your insurance plan and researching it to see if your dentist is considered to be in network or non-network.
If you still have questions or cannot find this information, the next best step is to call the dentist’s office and ask if your insurance is accepted and to what degree they will cover certain procedures. Due to the busy nature of most practices, expect a receptionist to take down your information and call you back at a later time with the information you requested.
A Word About Dental Insurance and Choosing A Dentist
Dental health can be an excellent barometer for the state of an individual’s overall health. To that end, it is crucial to see a licensed dentist that has years of valuable experience and that cares about their patients.
Patients should choose a dentist that:
- Is highly recommended
- Possesses years of valuable experience
- Offers convenient hours
- Is located centrally
- Puts patients first
Dental insurance can play an important role in selecting a dentist, but it should not be the only guideline for choosing the right dentist. Trust in the provider and peace of mind should also be considered.