If you have dental insurance and are looking to get the most from your policy in Del Mar, this blog from Del Mar Dental Studio is sure to help. We’ll look at a few simple tips you should keep in mind while getting dental care. Read on, and maximize your benefits.
1. Know The 100-80-50 Coverage Rule
It would be nice if dental insurance just paid for all of your dental care with no “catches” or fees, but this isn’t the case. Instead, most insurers use what’s called the “100-80-50” coverage method. This means that:
- 100% of your preventive care is covered. This usually includes teeth cleanings and oral exams
- 80% of basic dental care is covered. This usually includes fillings, root canals, and some other treatments
- 50% of major dental care is covered. This can include dental bridges & crowns, dentures, and more
Basically, the more significant your oral health issues are, the more you’ll pay out-of-pocket. That’s just another reason why good at-home oral hygiene is important.
2. Take Advantage Of Your Six-Month Dental Cleanings & Oral Exams
Because 100% of preventive care is covered by most dental plans, you can get two oral exams and teeth cleanings and a set of annual x-rays at no out-of-pocket cost. Make sure you take advantage of this.
Regular teeth cleanings keep your mouth healthy and help you avoid future issues, and they’re included as part of your premiums, so if you don’t use both visits, you’re not making the most of your benefits.
3. Check For Additional Benefits For Your Kids
Kids often have additional coverage for preventive dentistry. Kids under 18, for example, usually qualify for free fluoride treatments and dental sealants, though this may vary between dental plans. Check with your provider and your insurance information to see if your children can get additional benefits.
4. Be Aware Of Your Annual Maximum & Yearly Deductible
Your yearly deductible is the out-of-pocket amount you must pay before your insurance coverage kicks in. Most plans set this at $25 to $250. Once you reach this amount, your insurance will cover your care according to your plan details.
This will continue until you reach your annual maximum, which is usually between $1,000 and $2,000. After this, your coverage will no longer pay toward your treatment for the rest of the year. All remaining costs must be paid by you out of pocket.
5. Choose An In-Network Dentist
Most dental insurance plans are PPO, meaning that you get more coverage when you visit an “in-network” dentist. You can still see out-of-network providers, but you may not get the same level of coverage through your insurer. So, when possible, your primary dentist should be in your insurance network.
Get The Dental Care You Need From Dr. Todd Pizzi – Contact Del Mar Dental Studio
At Del Mar Dental Studio, we work with many major dental insurance companies. And, even if you’re uninsured, we offer reasonably-priced care with payment plans from CareCredit available to help you get the dental treatment you need, even if you’re on a tight budget. Contact us online or give us a call at (858) 755-0187 to schedule your appointment with Dr. Todd Pizzi and learn more.
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