Dental benefits are designed to save you money.
But even with coverage, some dental care costs aren’t reimbursed by your insurance carrier. Here are 5 reasons you may have an out-of-pocket dental expense:
1. You haven’t met your deductible yet.
A deductible is the amount you’ll pay for treatment before your insurance helps cover the costs. In general, your first few treatments of the year will go toward your deductible.
2. Your insurance carrier only covers part of the service.
After your deductible is met, your insurer will pay for a percentage of treatment costs, and you may be required to pay the remaining balance. This is known as coinsurance.
3. Your treatment requires a copayment.
Some plans require a fixed amount (copayment or copay) to be paid before treatment is received. Copays are predetermined and will stay the same for the plan year, no matter how much the dentist charges.
4. You have exceeded your annual maximum.
Most dental plans have an annual dollar maximum, or the maximum dollar amount that the insurer will pay toward treatment for that year. If you’ve exceeded your annual maximum, you will be responsible for all treatment expenses until your plan resets.
5. Your treatment isn’t covered by your plan.
Dental coverage depends on your plan’s specific design, and not all plans cover all treatments. Log in to your account to learn specifically what benefits are covered and which are not covered.
Note: Preventive care is almost always covered (and often at 100%), so make sure you’re scheduling your 6-month appointments!
When it comes to budgeting for out-of-pocket expenses, knowledge is power! Sign in to learn the details of your plan before you visit your dentist.