You have dental insurance, or maybe you’re still thinking about signing up for a plan. Either way, have you actually sat down and read an entire policy? If you’re like most people, probably not! Because of this, there is a lot of terminology that you might be familiar with despite not knowing exactly what it means. A prime example is the word “deductible.” It’s a central part of 99% of dental insurance plans, but what exactly is it? And more importantly, what should you know so you can save as much as possible with your insurance during your next trip to the dentist?
Deductible Basics
Thankfully, whether you have a plan with Delta Dental, Guardian, Cigna, or another provider, deductibles basically work the same way. It is a (relatively) small amount of money that you have to pay for dental care before the benefits of your plan will start.
Typically, it’s about $100-150. Once you spend this much at the dentist, your insurance plan will then start covering your care per the details of your benefits. This often does not apply to preventive procedures like checkups and cleanings…those are covered 100% from the beginning whether you’ve paid your deductible or not. Often, a deductible is only required if you want your plan to help cover restorative procedures like fillings, crowns, or dentures.
Why Do Deductibles Exist?
As you can imagine, deductibles aren’t really for your benefit, but rather they help out the insurance company. Firstly, they present an obstacle between a patient and more expensive procedures. By making a patient pay first, this discourages them from undergoing a potentially costly treatment that the insurance company would then need to help pay for.
And, if a patient ends up needing less than $100 in restorative care in a year, this is simply too low for the insurance company to bother with when it comes to handling the claim and processing it.
What Everyone Should Know About Deductibles
Most dental insurance plans reset at the beginning of the year. The most important things this applies to are the annual maximum (the highest amount of money a plan will pay for dental care in a given year) and the deductible. Once the new year begins, you will have to pay your deductible again before your coverage starts.
So, if you have already paid your deductible for the year, make sure to get any additional care you might need before the new year. This way, you can take advantage of your coverage and not have to pay the money again to take care of a problem you could deal with right now (while spending less!).
Of course, “deductible” is just one of the many potentially confusing aspects of dental insurance, but thankfully, you don’t have to decipher a plan by yourself. Simply reach out to the dental team you wish to visit and mention your current plan or one you’re considering. They’ll be able to answer your questions so you feel certain about what is and isn’t covered and know how much you’ll be expected to pay out-of-pocket.
About the Practice
The Chardon Smile Center is based in Chardon, OH and led by Dr. Christopher Phillips and Dr. Brian Titus. They are dedicated to providing their patients with high-quality and affordable dental care, so if you have any questions about dental insurance, they are eager to answer them. For more information or to book an appointment, you can reach them at their website or call them at (440)-286-2474.