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Everything You Wanted to Know About Dental Insurance

Dental insurance sheet next to tooth replica, glasses and calculator

Dental insurance can be much less confusing for patients to understand compared to medical insurance. The language used in dental insurance policies directly tells people what procedures receive coverage, how much you have to pay, and how much the insurance provider pays. However, people wind up leaving money on the table when their insurance plan rolls over at the end of the year. Whatever the difference between their maximums and what they spent on dental procedures is, they lose that money. To maximize the benefits of their dental insurance plans, patients need to understand what is currently offered, what kind of procedures are offered, and how much their insurance will cover. 

Knowing Your Coverage

Most dental insurance plans follow the 100-80-50 structure. They will cover 100% of the costs of minor procedures such as bi-yearly visits, teeth cleanings, x-rays, and dental sealant procedures. For things such as cavity fillings, root canals, and gum disease, your insurance will cover around 80% of the total cost after the deductible is met. The major procedures like crowns, bridges, inlays, or dentures will only have about 50% of the procedure covered. Knowing how much your insurance will cover helps you plan out your visits and maximize the money still left on your account before losing it at the end of the year. 

What If I Have an FSA Account?

Flexible Spending Accounts, or FSA, are provided through employer-sponsored insurance plans and are designed to help provide flexibility in how you pay for specific procedures. During your enrollment period, you select which FSA account you want and determine how much money is in that account. These pre-tax dollars come out of your paycheck over the year and are then used to help cover the cost of these procedures. 

The FSA plans work similarly to a debit card in that the money in the account can be withdrawn to cover the expenses. However, like other benefits, once the new year comes and the plan rolls over into 2021, you lose whatever balance is left on the FSA account. This is why you should take the time to plan out what dental procedures you need done throughout the year and do what you can to maximize the money in your FSA account. 

Where Do I Go From Here?

That’s the most important question right now. Since you only have a set amount of time left in the year to utilize your dental insurance benefits to their fullest, don’t wait! You can schedule an appointment to get your teeth aligned in Middlesex County, NJ, or get dental sealants in Burlington County, NJ; your friendly neighborhood dentists at Hamilton Dental can help you out! Contact our team today to plan your next visit!