Dental Insurance Explained

March 14th, 2018




Your primer for protecting your gums, teeth and mouth

So, it’s time to enroll in your benefits and you’re wondering, “Do I really need dental insurance? What does it cover and how does it work?” Let’s get your insurance knowledge up to speed and talk about why dental insurance is important for you.

What is dental insurance? It’s health insurance for your teeth, gums and mouth. It gives you the security and peace of mind that your insurance will be there to help cover costs, should you face a major dental issue that you can’t pay off alone. It also supports you in the everyday, every-year costs of ensuring your dental health is A+.

Who should have dental insurance? People of all ages. Dental insurance is here to protect you (and your wallet) and limit your out-of-pocket costs. Whether you’re in need of your biannual cleaning, or a cavity’s got you sad-faced, dental insurance is here to help.

How does dental insurance work? You pay a small amount every month, either directly out of your paycheck or on your own. That’s called your premium. After you’ve met your deductible—the amount you need to pay before your insurer covers costs—your dental insurance covers either a portion or all of the costs for preventive, minor and major dental care.

What are the typical limits of dental insurance? Your dental insurance may not cover all dental needs. A typical plan has limitations, including the number of times per year you can get a cleaning, and some procedures may be excluded. Check your plan booklet and obtain a pre-treatment estimate for more information on limitations and exclusions.

Dental Insurance Vocab:

  • Your maximum is the most money a dental plan will pay within a benefit period. This depends on your type of insurance.
  • Coinsurance is your out-of-pocket cost after you’ve reached your deductible.
  • Your reimbursement level is the amount you’ll receive back from your insurer, depending on the procedure you receive.
  • Copayment: This is a fixed dollar amount for certain covered services. When you enroll in your insurance, you receive a list of covered services and their copayment amounts.
  • A pretreatment estimate helps you plan ahead for the cost of extensive dental care. It includes an overview of services covered by your dental plan and can help you predict your out-of-pocket costs. Ask your dentist for your estimate.

Dental insurance can seem complex, but we’re always here to help you sort through what works best for you. If you have any questions, visit us at DeltaDentalMN.org.