More Americans than ever have dental coverage. Although only 23% of adults in the U.S. don’t have dental insurance, the Centers for Disease Control and Prevention estimates one-third haven’t been to the dentist within the past 12 months. Despite access to affordable dentistry, less than 3% of policyholders reach or exceed their annual limits. Let’s face it, dental insurance can be confusing, but you don’t need to throw money down the drain. The first step to using your benefits before they expire is choosing between an in-network or out-of-network dentist. Here’s what you need to know to make the most of your monthly investment.
Understanding the Basics of Dental Insurance
Every month, you pay a premium for your specific insurance policy, which provides discounted rates for the services your teeth and gums need to stay healthy. You can visit your dentist for cleanings and checkups without worrying about a large bill. If a problem arises, you can use your benefits to offset the amount you’ll pay out-of-pocket. After reaching your annual deductible, your dental insurance can pay up to 80% of the cost until hitting your yearly limit, which can range from $1,000 to $2,000.
Unfortunately, your benefits don’t last forever. At the end of the calendar year, your policy will expire. You will not be reimbursed for your premiums or deductible. Any remaining allowance that wasn’t used won’t carry over into the new year. You’ll lose everything you paid throughout the year.
Choosing the Right Dentist
Contrary to what you might have heard, you can visit any dentist who accepts your dental plan, even if they aren’t in-network. Your insurance carrier recommends an in-network dentist because they have pre-negotiated rates to lower the amount you pay. You’ll enjoy more coverage and benefits at the time of service instead of having to wait for pre-authorizations and approvals.
Although it’s preferred to visit any in-network location, you can choose one that’s out-of-network. You can still use your dental insurance, but you’ll need to pay the difference between the dentist’s fees and your policy’s allowable amounts. While you’ll have more freedom to choose the exact dentist you want and expanded treatment options, it can take longer to navigate your insurance company.
Maximize Your Dental Insurance
If you have remaining dental benefits you’re about to lose, an in-network dentist can provide the reasonably priced care you need without having to worry about any insurance-related delays. Your dentist will work on your behalf with your insurance company to file the necessary claim forms to maximize your coverage. You can invest in a healthy, beautiful smile without adding any financial burdens.
About Dr. James A. Moreau Jr.
Dr. Moreau has over 40 years of experience in dentistry. His career and clinical excellence have afforded him memberships with various professional organizations, including the American Board of Dental Sleep Medicine and the Academy of General Dentistry. He is in-network with many leading dental insurances to provide cost-effective services. If you’re ready to schedule an appointment or have a question about your coverage, contact our office today.