Why Does Dental Insurance Cover So Little of My Treatment? 

You just saw the dentist for the first time in a couple of years. To no one’s surprise, you discover that you need a couple of fillings and a crown. you don’t floss and even enjoy a soda a couple of times a week. over time, your teeth have taken their toll.

Reading: Why does dental insurance cover so little

“I’m fine,” you think to yourself, “after all, I have dental insurance.”

However, once you sit down with the treatment coordinator, you discover that your dental insurance doesn’t cover nearly as much of your plan of care. in fact, she almost seems like she’s left paying most of it out of pocket for him.

Is dental insurance just a big scam?

Having dental insurance is great when you don’t need a lot of treatment. paying a policy each month is enough to cover all your preventive services (checkups and cleanings) and maybe a little more. so if you need one or two fillings, you can schedule the procedure without worrying about going over your maximum allowable benefits for the year. A maximum allowed is a fixed dollar amount that your insurance will pay up to, but not more.

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Keep in mind that you also have a deductible or copay that you must cover out of pocket before your insurance will pay for dental treatment. there is a fine balance of math that needs to be done. For some people, having dental insurance can help them budget better and save a few hundred dollars a year, or at least get a discount on a filling once in a while. for others, it’s more expensive to have insurance because it doesn’t cover what they need.

how to know what dental treatments are (or are not) covered by insurance

As a general rule, your dental treatments fall into a few different types of services, each with a different level of coverage. preventive services, like cleanings or exams, are usually covered at 100%. it is when the preventive treatment passes that your insurance stops paying so much.

Basic or minor treatments, like small fillings, are partially covered (usually about 75-80%), but only after you’ve paid your deductible and any copays. however, if you have too many core treatments that need to be completed, you may run the risk of going over the maximum amount allowed before everything is done.

Now let’s say you need some important work, like a crown. your dental policy coverage is further reduced, to around 50%. If you need to work on more than one tooth, the additional teeth are most likely not covered because you have already reached your benefit limit.

Finally, elective services such as dental veneers, teeth whitening, etc. are never covered by dental insurance. they are considered cosmetic, so they are not medically necessary.

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“I thought dental insurance was supposed to cover everything I needed”

Depending on how you look at it, dental insurance helps cover everything you need…but only if your needs aren’t too great. If you visit the dentist regularly and treat cavities or dental problems when they are small, you can get more out of your insurance coverage. it is when problems are postponed for a while or are very complex that most people are forced to pay for most of their dental treatment out of pocket.

Prevention is the best medicine…especially when it comes to your teeth. If you have dental insurance, take advantage of coverage for preventive services, so you can save more money over time.

alternatives to save money instead of buying dental insurance

For people who need a lot of dental work but have limited coverage in their dental insurance plan, it may be best to enroll in a savings program. discount dental plans apply a pre-negotiated discount to every treatment, no matter how much or how expensive it is. yes, that includes everything…whether necessary or elective (such as cosmetic treatments). With no maximum allowable limits, waiting periods, or exclusions, many people find discount dental plans more effective than traditional types of insurance.

Learn more about signing up for an affordable dental savings plan that covers what you need to keep your smile healthy. Contact the experts in affordable dentistry at aetnadentaloffers.com today.

*Actual costs and savings may vary by carrier, service and geographic location. †Family plan calculations are based on a family of two adults and two children.

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