When you need dental work in the Marysville, WA, or Smokey Point area, you may be wondering about how your dental insurance will work before you have any procedures. Perhaps you’re looking for a new dentist, and you know which type of insurance you have will factor into your decision.
It’s normal to have questions, and this handy guide from Seven Lakes Dental will help. After all, it’s our goal to make you more comfortable during your visit.
Most People Have Private Coverage from Work
If your employer offers benefits, most likely, you have dental insurance from your job. This applies for non-Medicare and non-Medicaid plans, in most cases.
Check with your employer to see if you have insurance. A human resources employee should be able to give you information about your dental benefits.
Employers Fund Some Plans
Direct Reimbursement Plans are funded by your employer, who will reimburse your dental costs. This will of course vary by employer, but the main benefit is that you do not have to stay within a network when choosing the right dentist. You’ll also not have to worry about deductibles, authorizations, or premiums.
Your Choices of Dentist Will Vary
Different dental plans will determine your choice of dentist in some cases.
Indemnity plans cover all ages, and cover basic care such as screenings, cleanings, and procedures such as fillings. They also partially cover more in-depth services such as crowns and oral surgery. Some plans also cover orthodontics. Usually, you can choose your own dentist, but these plans tend to be more expensive than others.
A PPO plan, however, will require you to use an in-network dentist, which is good to know if you’re changing providers.
DMO plans assign you a dentist, and though they minimize your out-of-pocket costs, switching dentists is not easy. If you need a specialist, he or she will need to be in the network, which is often small.
Plans Usually Follow the 100-80-50 Rule
No matter which plan you choose, most often, the 100-80-50 rule applies.
In most cases, plans cover one hundred percent of preventative services such as X-rays, screenings, and having your teeth cleaned. These services are typically cheaper than procedures that fix dental problems such as impacted teeth and tooth decay.
Most dental plans cover eighty percent of basic procedures such as simple fillings and extractions. Root canals are also often considered basic procedures.
Major procedures such as implants, crowns, and bridges are most often only covered by half.
Seniors can benefit from senior dental plans which can cover more costs of these major procedures, as they’re more likely to require more major dental work than other populations.
Cosmetic Dentistry is Usually Not Covered
Most dental insurances don’t cover orthodontics or cosmetic dentistry, making these procedures expensive in most cases. However, indemnity plans are the most likely to have this coverage, but they are the most expensive type of plan and not as common as others.
Have Questions?
No dental insurance? We’ve got you covered! Ask about our Patient Loyalty Program 12-month discount plan and save 20% off all services. Call (360) 653-5577 for program details.
At Seven Lakes Dental, we’re committed to making your experience as comfortable as possible. We’re here to make your appointment as smooth and relaxing as we can and are happy to answer your questions. Be sure to reach out to us with any questions you may have about your visit with us.
