Understanding and Using Your Dental Insurance

dental insurance dental benefits family dentistry in KnoxvilleMillions of dollars of dental benefits go unused each year. The insurance company is paid their premiums, but a surprisingly high percentage of people do not take advantage of the insurance paid for, leaving money (in the form of benefits) on the table, even if they have dental needs.

You are paying for your dental benefits in some way, even if they are part of your employment benefit package that was offered as part of your wages. The insurance companies make more money when you let your benefits go to waste.

We encourage you to use your dental benefits every year, whether you only need preventive care or have a lot of problems with your teeth.  Taking care of your teeth will:

  • Prevent pain and emergencies
  • Save you money in the long run
  • Help you keep your natural teeth
  • Or, replace them if they are lost
  • Positively impact your overall health
  • Keep you smiling
  • Avoid having to go over your insurance yearly maximum

There are thousands of dental insurance plans available and it is important to understand what yours covers.  You may have been sent a packet of information or can call the insurance company directly to learn more.  Keep in mind that there may be exclusions and limitations that are not described in the general materials.   Here are a few things to look for:

Yearly Maximum The dollar amount of benefits available to you each year. If not used, they often go away on December 31st of each year.

Deductible: The amount you need to pay each year before the insurance company starts paying.

Preventive Payment Percentage: This percentage usually applies to x-rays, cleanings, and exams.

Restorative Percentage:  These benefits are for more minor treatments like fillings or periodontal care.

Major Percentage:  This is the percentage paid on approved crowns, bridges, dentures, and other major treatment.

  1. Keep in mind that these percentages are not usually based on your dentist’s fee, but an amount  predetermined by your insurance
  2. Most plans have a limit on how often you can have preventive care
  3. Some plans exclude implants, tooth colored fillings, and other treatments
  4. Most plans have a frequency limit on major and restorative treatment
  5. Your dental office can get a written pre-authorization estimate from the insurance company on major treatment
  6. Insurance companies will often pay for the least expensive way to resolve a dental issue
  7. Some plans only pay in specific dental offices

In our office we are happy to check insurance benefits for our patients and help them understand what they mean.  We give clear, easy to understand estimates before treatment is started.  We have been at this for years and love helping people understand and use their insurance to take care of themselves.

If you have insurance, there is no reason to delay calling and setting up a dental appointment.  If you are in the Knoxville area, we would love to serve you.

Ron Smith, DDS – Family and Sedation Dentistry – Knoxville TN – (865) 922-1613

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