How does dental insurance work?
Learn how dental insurance can benefit your long-term dental health.
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Benefits of dental insurance
Most health insurance plans don't include dental care. Dental insurance is purchased separately from your regular health coverage. Like other types of insurance, you'll pay a monthly premium and you'll receive coverage for certain care.
You'll also pay a part of the total cost of care with either coinsurance or a copay. Coinsurance is a percentage of the total price, while a copay is a set fee paid by the patient.
With a focus on preventive care, dental insurance helps you cover regular visits that help catch problems early. It also helps pay for unexpected treatments or major procedures, so you don't have to pay as much on your own.
What dental insurance typically covers
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Preventive care
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This includes routine preventive check-ups, cleanings, and X-rays. These will likely be fully covered with no out-of-pocket costs or a very low copay.
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Basic services
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This includes fillings for cavities, tooth extractions, and some treatments for the gums and tissues around the teeth. These are typically covered at a lower percentage.
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Major services
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This includes more extensive care such as crowns, bridges, and dentures. These are usually covered at a lower percentage, with patients paying a higher amount than with basic services.
Finding the right care
While your general dentist does your cleanings and preventive care, there are many other types of speciality dentists who provide major services that may be partially covered by dental insurance.
Understanding the different types of dentists can ensure that you receive the care you need quickly.
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General dentist
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This is your go-to provider for preventive, diagnostic, and routine dental care. Their services include exams, cleanings, X-rays, fillings, crowns, bridges, and basic dental procedures. Your general dentist may also perform root canals, implants, and cosmetic procedures.
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Pediatric dentist (pedodontist)
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These professionals specialize in dental care for children, from infants to teens. They focus on preventive care, cavities, and other issues common with children.
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Orthodontist
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Orthodontists correct crooked teeth and jaws with braces, clear aligners, or other orthodontic devices. They treat overbites, underbites, and crossbites to improve function and appearance.
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Cosmetic dentist
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Cosmetic dental specialists improve the appearance of your teeth and smile through teeth whitening, veneers, crowns, inlays, and tooth-colored fillings.
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Endodontist
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Endodontists typically perform root canals, but these dentists work on many complex issues of the tissue, blood vessels, and nerves inside your tooth. They work to relieve pain and save your teeth from tooth decay, injuries, abscesses, or cracks.
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Periodontist
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These specialists focus on diseases and conditions that affect the gums and tissue around your teeth. A periodontist performs deep cleanings, gum grafts, and dental implants. They also help prevent, diagnose, and treat gum disease.
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Prosthodontist
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If you have missing or damaged teeth, a prosthodontist may be the best choice. These professionals help patients fit dentures, bridges, crowns, and implants. They also provide cosmetic services or treatment for temporomandibular (the joints that connect your lower jaw to your skull) disorders.
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Oral and maxillofacial surgeon
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Specializing in surgeries on the mouth, jaw, and face, oral surgeons can correct cleft lip and palate and jaw deformities, as well as perform tooth extractions, dental bone grafts, and oral biopsies.
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Oral pathologist
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Oral pathologists diagnose and treat oral cancer, infections, and lesions. They focus on issues with the teeth, gums, bones, joints, skin, and muscles around the mouth. They work closely with other medical specialists for complex conditions.
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How to choose the right dental plan
When it's time to pick a dental plan, consider your budget, preferred dentist, frequency of visits, and the dental needs of all covered family members.
Review the features of each plan, including premiums, coverage limits, copays or coinsurance amounts, and any waiting periods for services. That way, you can choose the plan that best helps you meet your dental goals.
Take the confusion out of insurance
Get reliable answers to your insurance questions, such as how to get prior authorization and submitting a claim.
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