Insurance Deductibles: What Are They & How Do They Work?

July 28, 2023

Filed under: Dental Hygiene — devotedfamily @ 4:45 pm
a bill from dental insurance

Dental insurance can be complicated to navigate, especially due to the fact that every plan is different. Fortunately, there are some important basics that apply to most plans and learning them can give you a better idea of how your insurance operates, like what a yearly deductible is and how it works. Read on to learn more about insurance deductibles and how to maximize your savings for the year.  

How Does Dental Insurance Work?

Unlike medical insurance, dental insurance is more focused on prevention instead of treating problems as they arise. That is why you are able to save the most by keeping up with your routine checkups and cleanings, which help you avoid oral health problems or treat them as early as possible, when they require less extensive intervention. These visits are also typically 100% covered by insurance plans.

In order to receive coverage, you will need to pay a premium, which is a set monthly or annual amount. If you have a PPO insurance plan, you’ll be able to choose your provider, regardless of whether they’re in-network with your plan. With HMO plans, you will be required to choose a provider that is specifically contracted to accept your insurance plan.

Once you understand these basics, it will be easier to understand the grittier details, like what your maximum is. This is the set amount that your insurance company will pay out for your treatments over the course of a calendar year. All of these details are determined by your provider, so you will want to confirm the amounts and in-network coverage with them directly before scheduling an appointment or going into a dentist for treatment.

What is a Dental Insurance Deductible?

Your insurance deductible is the amount that your insurance provider will require you to pay out-of-pocket before your benefits kick-in. The average plan’s deductible can range from around $50 for an individual to $200 for a family, but this can vary. In some cases, dental insurance plans will not charge you your deductible for preventive services, like your bi-annual checkup and cleaning, and sometimes fluoride treatments.

How Can You Maximize Your Savings?

Many dental insurance plans’ benefits are renewed on January 1st, at the beginning of each year. If this is the case for you, you can also expect your deductible to restart at this time. That is why to save the most money, it is recommended to get any necessary treatments you need before the new year, so you only need to pay your deductible once.

With this helpful savings tip, you can minimize your out-of-pocket costs, take care of your smile, and get the most out of your investment in insurance, all at the same time. Although dental insurance may seem frustrating and complicated to parse out, when you understand the nuanced details of your plan, you will be able to use it to the fullest extent.  

About the Practice

At DuPont Family Dentistry, our team is led by three highly experienced dentists dedicated to providing accessible, outstanding dental care. Our practice is proud to be in-network with several major PPO dental insurance providers, including Delta Dental, Aetna, and BlueCross BlueShield, to help patients maximize their coverage and save money. With lower fees and discounted services, our patients are able to take care of their smiles with less stress. For questions or to schedule an appointment, visit our website or call 253-946-7000.

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