Do you understand all the details of your dental insurance? Most people do not, and the insurance companies hope that you don't! Here are a few examples of some common dental insurance FAQs:
Deductible: $25-$50. This applies typically to basic and major work and is commonly waived on preventative work.
Yearly maximums: $1000-$2500. This amount is typically reset each January. Preventative work is subtracted from this total.
Preventative is typically covered at 100% and includes new patient exams, periodic and periodontal exams, FMX(full mouth x-rays) every 3-5 years, Bitewing x-rays every 6 to 12 months, fluoride treatments usually for dependent children to the age of 16 years, sealants to the age of 16 years, prophy and/or periodontal maintenance twice per calender year or once every six months.
Basic coverage is generally covered at 80% and includes fillings, oral surgery,periodontic and endodontic(root canals) treatment. Very often insurance companies provide the alternative benefit of amalgam for fillings to posterior teeth. What this means is that although the standard of care for all teeth is to place composite resin fillings (white colored fillings) on all teeth, they pay for amalgam fillings and force their customers(you!) to pay the difference!
Major work is generally paid at 50% and includes crowns, bridges, partials, and dentures. There is usually a replacement frequency of every 5-10 years for these services.
Occasionally there is a waiting period for basic or major work . Also, sometimes, insurance companies have a missing tooth clause. This means that if you lost or had a tooth extracted prior to have that dental coverage, they will not pay to help you restore your teeth with a bridge or partial.
I hope that this helps you to understand your benefits a little better. If you have additional questions, please contact my office.
Brian Johnson DMD
1240 Upper Hembree Road
Suite C
Roswell, GA 30076
(993)993-9809
www.BrianJohnsonDMD.com
BrianJohnsonDMD@gmail.com
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