How Dental Insurance Works

portrait of a smiling family The Amazing Smiles team wants our dental care to be as affordable as it is high quality. To help, we are pleased to accept a number of popular insurance providers. We also file and process all insurance claims to make sure you get all the benefits you are entitled to from year to year. Please do not hesitate to call our office at any time to discuss the particulars of your insurance plan.

To really make the most out of your dental insurance, it’s important to understand just how it works. We’ve put together a brief FAQ to help. Still have questions? You’re always welcome to get in touch with our team of insurance experts!

Q: What’s the Difference in In-Network and Out-of-Network?

A: An in-network dentist is one that is contractually bound to provide certain dental services at a predetermined fixed rate for you. Unlike with your medical insurance, you may still be eligible for the same savings visiting an out-of-network dentist if you have a PPO (preferred provider organization) plan.

Q: What Is a Premium?

A: The premium is the amount you or your employer pay, usually monthly, in exchange for your dental insurance coverage. Most premiums range around $50 per month, which makes you eligible for potentially hundreds of dollars worth of care after you have met your deductible (see below) for the year.

Q: What Is a Deductible?

A: The deductible is the amount you must pay out-of-pocket per year before your dental insurance coverage will take effect.

Q: What Is a Copay?

A: Your copay is the amount of money you are obligated to pay at each dental visit. The copay ranges based on your insurance plan -- some people don’t have to pay anything at all.

Q: What Does My Dental Insurance Cover?

A: Dental insurance coverage varies widely depending on how much you pay as a premium, but the basics remain the same. Preventive care, which is the foundation of every healthy smile, is fully covered under most insurance plans. You are eligible to receive two checkups and cleanings with X-rays per year absolutely free with dental insurance.

Q: What Is NOT Covered By Dental Insurance?

A: Usually, anything that you don’t have to have to prevent or resolve oral health problems is not covered by dental insurance. That includes elective procedures, like most cosmetic treatments. Many dental insurance plans still do not provide coverage for dental implants (despite the fact that they are the best option) since there are cheaper options available.

Q: How Can I Make the Most Out of My Insurance?

A: The Amazing Smiles team will be happy to help you get the most out of your investment in dental insurance. We will start by performing a verification of benefits, when we call your provider to find out just what you are eligible for. Making sure you take full advantage of all services offered within a calendar year is important, since most dental insurance plans do not roll over from year to year. Our dental insurance experts can help you make strategic decisions to maximize your benefits.

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