How to make the most of your dental insurance

When people choose health plans, dental coverage is often an afterthought. Yet cost is one of the most common reasons people put off dental care, and many patients with insurance leave benefits unused at the end of every year. Understanding how your plan works makes it much easier to stay on top of your oral health without surprises.

Why regular visits are worth it

Many dental problems, including cavities, gum disease and oral cancer, cause no pain and aren’t visible until they are advanced. Regular checkups find them early, when treatment is simpler and less expensive. Read more about why routine checkups matter.

How dental benefits usually work

Every plan is different, but most follow a similar pattern:

• Preventive care, such as checkups, cleanings and routine X-rays, is often covered at a high percentage, sometimes in full.
• Basic care, such as fillings, is usually covered at a lower percentage.
• Major care, such as crowns, bridges and dentures, is typically covered at a lower percentage still, sometimes after a waiting period.
• An annual maximum limits how much the plan will pay in a year.
• A deductible may apply before coverage begins.

Cosmetic treatments such as whitening are usually not covered.

Tips for getting the most from your plan

• Use your preventive visits. If your plan covers checkups and cleanings, you’re paying for them either way.
• Know your plan year. Annual maximums usually reset, often on January 1, and unused benefits generally don’t carry over. If you need treatment, planning it around your plan year can help.
• Ask for a pre-treatment estimate before larger procedures, so you know what to expect.
• Don’t put off small problems. A small filling now is usually covered better, and costs less, than a crown later.
• Keep your information up to date with the office whenever your plan changes.

Insurance at SmileNY Dental

We accept most dental insurance, including many PPO plans from major carriers. See the plans we accept. Plan participation can change, so please call us with your plan details before your visit, and we’ll help you understand how your benefits apply. For questions to ask before you book, read what to ask about insurance.

Your insurer is the final word on what your plan covers. An estimate of benefits is not a guarantee of payment. Contact us with any questions.