Saving money at the dentist’s office can be challenging if you are unfamiliar with dental insurance and how it works. You know it can help lower your out-of-pocket costs, but frequently used terms, like “deductible,” may leave you feeling unsure about what is required to access to all these supposedly “great” benefits. Keep reading to discover the meaning behind this important word and how it can lead to the kind of savings you deserve.
What is a Deductible?
A deductible is the designated amount your dental insurance company decides you must pay for covered restorative services before they begin to pay their portion. Deductibles are typically not applied toward preventive care, as these are usually covered at 100% by the insurance company.
How Does a Deductible Work?
Generally, deductibles are set based on a regular calendar year (January to December). This means that yours resets on January 1, requiring you to “meet it” or pay the amount once again before your insurance will step in to help cover a portion of the total costs.
An example of this might look something like the following:
Your deductible is $50, and you require a covered dental treatment that is $500. Before your insurance company pays anything, you will need to meet your deductible of $50. Once you do, your remaining balance will be $450. Based on whether you are receiving a minor or major restorative service, your insurer will pay 50-80% of the remaining balance.
Going forward, if you require additional treatment in the same year, you will not be required to meet your deductible again.
You will, however, likely be required to pay coinsurance, which is your portion of the cost after insurance pays its share. If you have 80/20 coinsurance, you can expect to pay 20% of the total cost, while your insurer will be responsible for 80%.
How to Get the Most Out of Your Plan
If you want to avoid paying more for dental care, there are several things you can do:
- Continue to see your dentist every six months for regular checkups and cleanings, as this will not require you to pay a deductible but will keep your mouth healthy and in the best shape possible.
- If you need restorative care, pay your deductible as early in the year as you can. This will help you avoid additional costs down the road should you need more complex oral healthcare later in the same calendar year.
- Understand that keeping your teeth and gums healthy minimizes the amount you’ll be required to spend on more advanced forms of restorative dentistry.
Having questions about dental insurance is normal, so don’t hesitate to ask for help if you need it. Knowing more about the kind of plan you are considering will increase your chances of choosing one that will give you the best return on your oral healthcare investment.
About the Author
Dr. Casey Hammond is one of two dentists leading the charge at Dental Group of Jefferson. After achieving his dental degree at Ohio State, he completed advanced training and received hands-on experience to become certified in dental implant placement and Invisalign. Delivering state-of-the-art care to patients with all types of oral health problems, he and his team are pleased to be in-network with many different dental insurance plans so that dental services remain more affordable. If you have questions about your policy, visit our website or call (440) 576-7040.