I don't understand my dental insurance

I don't understand my dental insurance, can you help?


Dental insurance can be very confusing to the consumer because the word insurance is misleading. Dental insurance is better described as a Dental Benefit, designed to assist in dental costs. Dental benefits usually cover most or all of Preventive care, such as regular cleanings and exams. Then it is usually outlined what benefit is allowed for fillings, crowns, periodontal care, root canals, and more.


A question we get asked a lot is, "How much and what kind dental care can I have done with my type of insurance?"


Often, we can check within our own computer system and verify this information, but most of the time calling your insurance company or going to your insurance company's website is your best bet.


Dental insurance companies will NOT give any specific information, only "general" information, to a Dental office, even a predetermination is not guaranteed. That is why we always describe it as a Dental Benefit.


If you don't have an online account with your insurance company, GET ONE! Most offer this as an option. You can check your benefits, estimate costs, and verify if your claims have been paid.


Most dental insurance companies allow for a maximum paid per year, this is often confused with how medical insurance describes maximum out of pocket. Most companies have not increased this dollar amount since 1975!


Something that cost $1 in 1975 would cost $4.01 today (per the inflation calculator). So you ask, "Why haven't my dental maximums increased 400%, I am sure my premiums have?" HMMM, good question!


You are the only one that can change this! Talk to your Human Resources department and ask this question, so they will ask the same question to the insurance company!