If you pay a premium for dental insurance every month, you probably want to make sure you get the most for your money. So in this blog from the office of Dr. Douglas G. Hope, we’ll discuss a few strategies and tips you can use to get the most from your plan.
Find An In-Network Dental Provider
Most dental insurance plans are PPOs (preferred provider organizations), which means that seeing an in-network dentist will be less expensive than seeing an out-of-network dental provider. While you can still see an out-of-network dentist, you will not get as many benefits, so it’s a good idea to pick an in-network dentist as your primary dental provider.
At the office of Dr. Douglas G. Hope, we will work with you to process your claim and work with your insurance company to make sure you get the most from your benefits at our office in Escondido.
Get Two Teeth Cleanings & Oral Exams Each Year
Almost all dental insurance plans cover 100% of the cost of two yearly teeth cleanings and oral exams, as well as annual dental x-rays. So make sure that you come to the dentist twice a year, or you’re leaving money on the table.
This is also important because it helps you catch potential oral health problems like cavities and gum disease. The sooner you get diagnosed, the sooner you can get the treatment you need, and this can help you avoid further complications and expensive dental care.
Know The 100-80-50 Coverage Rule
This may vary, so consult with your insurer to get the specifics. But most dental insurance plans cover your care in a 100-80-50 model, with:
- 100% coverage for all preventive appointments like dental cleanings and exams
- 80% coverage for “basic treatments” like fillings and root canals
- 50% coverage for “major treatments” like dentures, bridges, and crowns
This is another reason why proper at-home oral hygiene is so important. Avoiding serious oral health issues helps you save on out-of-pocket costs when getting dental treatment, even if you have insurance coverage.
Understand Your Yearly Deductible & Annual Maximum
It’s good to understand your yearly deductible and annual maximum. For example, most deductibles are between $25 and $250. Once you hit this out-of-pocket threshold, your dental plan will begin to pay out to cover the cost of your care.
Your plan will continue to pay for dental care until you hit your annual maximum, which is the cap on how much it will pay for dental care in a given year. This is usually between $1,000 and $2,000.
Both your deductible and annual maximum roll over at the end of each calendar year, so there are some situations where you may be able to save money by taking advantage of this.
For example, by getting one dental treatment in December and further dental care in January of the following year, you can make sure you don’t exceed your annual maximum for either year.
Need Dental Care In Escondido? Come To The Office Of Dr. Douglas G. Hope
Dr. Hope is always here to help you get the care you need in Escondido. We work with many major insurers to provide you with the care you need, and our new patient special and flexible financing options mean that you can keep your mouth healthy even if you don’t have insurance. So don’t wait. Contact us online or call at (760) 480-8883 to schedule an appointment with Dr. Hope today.
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