What Is Dental Insurance and What Does It Pay?
Traditional dental insurance is available for individuals and families to cover the cost of dental care without paying directly out of pocket. The most important question people have about dental insurance is what does it pay for? Traditional dental insurance pays for three classes of treatment, usually called preventative, basic and major services.
The first class of service is preventative or diagnostic. Usually dental insurance pays 100% for these services. What are preventative services? Plans may differ slightly, but most insurance will pay 100% for oral examinations and dental prophylaxis (cleanings). Each person on the plan will get two of these services each year.
In addition, insurance plans will pay for Bite-Wing X-rays once a year and a full mouth series of X-rays every 2 to 3 years. For children, preventative services paid at 100% will also include fluoride treatments and sealants.
The next class of service is usually called basic services. Dental insurance will pay for a high percentage, often 80%, of these services. Again, insurance plans may vary, but most define basic services as fillings, space maintainers, root canals and root planing, simple extractions, periodontal surgery and palliative (relief of pain) treatments. The percentage paid on these services will vary depending on the plan selected and the premium paid. The most common percentage paid is 80% but there are insurance plans available which will pay anywhere from 50 to 90%. How much is paid is directly related to the premium.
February 18 2011 | Dental Care For Healthy Teeth And Gums | Comments Off