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Insurance Basics with Your Dentist in Washington, DC

January 12, 2017

A dental insurance primer with your dentist in Washington, DC.Let’s face it: dental care can be expensive, especially if you have children. You should never have to make the choice between your bank account and their oral health, so you decide to make it more affordable by getting dental insurance. You’ve never had dental insurance before, so how does it actually work? Which treatments are covered? How much is the deductible?…is there even a deductible? Your dentist in Washington, DC, Dr. Yelena Obholz, is going to answer some of these basic questions, and more, so you can become more familiar with your dental insurance.

1. What Does It Cover?

Dental insurance is a little bit different than medical and auto insurance. Rather than being geared towards treating a problem that has already arisen, dental insurance’s aim is prevention. This is why many plans cover standard preventive care (like check-ups and cleanings) 100%. They are some of the most basic and effective ways to keep your teeth clean year in and year out.

When it comes to other procedures, it will depend on your particular plan. Most plans will cover a portion of restorative procedures (like crowns and fillings) or specialty treatments (such as periodontal therapy), but the specific percentage varies. It can all depend on if your dentist is in-network with your provider or not.

2. What Does It Mean To Be “In-Network?”

You will see a lot of practices saying that they are “in-network” with a certain insurance provider. This means they have negotiated with that particular provider to cover part of their fees. So if you have a plan from “X-Dental Insurance,” and your dentist is in-network with them, you will get more treatment covered than if your dentist is “out-of-network.” With in-network providers, savings can often be compounded, as a percentage of a treatment can be covered after a discount has already been applied. Always check to see if your family dentist in Washington, DC is in-network with your provider.

3. How Much Are The Deductibles

This is dependent on your particular plan, but the biggest influence on your deductible is whether you are on an individual or family plan. Individual deductibles typically range from $50-$250, while family plans are usually $100-$500.

4. Are There Any Waiting Periods?

Yes, depending on which treatment you are getting, there can be a waiting period of 6-24 months where your insurance will not pay for it. If you’re curious as to how this will apply to you, simply call your dentist so they can go over your plan.

5. What Is A “Missing Tooth Clause?”

This means your insurance will not cover any costs used to replace a tooth that was lost or extracted before you were on their plan.

Have More Questions?

Of course, we are merely scratching the surface when it comes to dental insurance. Finer details like how treatments are classified, annual maximums, and alternate benefits are all going to be different from individual to individual. So what do you do? How do you learn more?

Simply call us. The team at Aesthetic & Family Dentistry have been helping people understand and get the most out of their benefits for years. If you need dental care and have questions about how much your insurance will cover, just contact us today and we’ll be happy to walk you through your plan.

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