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Dental Insurance

Dental Insurance Information

Dental Insurance

Dental insurance is a type of health insurance designed to pay a portion of the costs associated with dental care.

Generally dental offices have a fee schedule, or a list of prices for the dental services or procedures they offer.
Dental insurance
companies have similar fee schedules which is generally based on Usual and Customary dental services,
an average of fees in your area. When a dentist signs a contract with a dental insurance company that provider agrees
to match the insurance fee schedule and give their customers a reduced cost for services,
this is considered an In-Network Provider or Participating Provider network (PPO).
Depending on your specific plan, if you seek an Out-of-Network or Non-Participating Provider,
any difference of fees will become the financial responsibility of the patient unless otherwise specified in your dental policy.
Some dental insurance plans may have
waiting period restrictions.
This is a period of time before certain benefits will be covered.
Often set in place when you are a new enrollee or seek out an independent plan outside of an employer or group.

Dental insurance companies set services or procedures into categories and refer to them with American Dental Association (ADA) codes.
As an example, Preventative and Diagnostic procedures often include exams,
x-rays, and basic cleanings or prophylaxis.
Basic procedures often include
fillings, periodontics, endodontics, and oral surgery. Major procedures often are crowns,
dentures, and implants. Procedures such as periodontics, endodontics, and oral surgery may fall into the
Major category depending on your specific plan with specific fee schedules and co-payments.
Many dental insurance plans offer free semi-annual preventative treatment.
Fillings, crowns, implants and dentures may have various limitations.

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