What Will Your Dental Insurance Plan Cover?

The end of another year is quickly approaching. In the hustle and bustle of the holiday season, it might be hard to remember that once the clock strikes midnight on December 31^st, any dental insurance benefits you haven’t used in 2022 will expire. To avoid wasting coverage you’re already paying for, you’ll need to know how to maximize your benefits. Once you learn the basics of what dental insurance covers, this should be much easier! Learn more by reading this simple guide to dental insurance coverage from your dentist in Chula Vista.

Preventive Care

Oral health problems are easier to prevent than they are to treat. So, most dental insurance policies will fully cover the cost of two checkups and cleanings per year. This means you can most likely enjoy a fresh and healthy mouth without paying anything out-of-pocket!

Minor Restorative Treatments

After you’ve paid your yearly deductible, your plan will probably cover minor restorative care at 70-80%. Plans can differ in what they deem “minor” or “major” treatments, but this category typically includes cavity fillings and nonsurgical gum disease therapy. Root canals might also be included in some cases.

Major Restorative Procedures

Your plan is likely to cover major restorative care at 40-50% of the cost up until you meet your annual maximum (the highest amount of money your insurance carrier will put toward your care in a given year). Tooth extractions, crowns, bridges, and dentures usually fall under this umbrella of services. As mentioned earlier, root canals and a few other treatments could be considered minor or major depending on the specific policy.

What Does Dental Insurance NOT Cover?

Dental insurance plans almost never cover cosmetic procedures, such as veneers and teeth whitening, because they’re considered elective and do not improve your oral health. Many plans also exclude orthodontic treatment. Additionally, dental implants aren’t often covered by insurance, but that is slowly beginning to change as more and more providers realize their benefits. Typically, they’re considered a major restorative procedure.

Since no two dental insurance plans are exactly alike, you’ll have to consult with your dentist to be sure which services your plan covers and to what extent. Your dentist’s team will be more than happy to explain your coverage, file claims on your behalf, and make sure you’re getting your money’s worth on your dental care!

About the Author

Dr. Eric Barajas has been a trusted dentist in Chula Vista, CA for more than 30 years now and has loved being able to make a difference in his patients’ lives by improving their smiles. His practice, Village Walk Dental, is in-network with many of the leading dental insurance plans. However, they’re happy to accept nearly all PPO plans and maximize your benefits on your behalf. If you have any questions about what your plan covers, please reach out to Dr. Barajas’ office by calling (619) 482-7367.