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How Does Dental Insurance Work?

Insurance Cards

Maintaining good dental health takes not only regular visits to your dentist but also takes a good understanding of how dental insurance helps cover the costs for your oral health treatments. However, amid the confusion of today’s highly-costing insurance companies and dental practices’ struggle with processing payments, patients using insurance has become a massive challenge in today’s medical market. As dentists, our goals alongside treating patients involve teaching people about their insurance and helping them throughout the process.

The Basics of Dental Insurance

Dental insurance runs on a completely different set of rules; compared to generalized medical care, dental insurance is often run by private companies. For each patient, that private company will have unique plans designed with the patient in mind. Patients who select these plans will have a specific collection of dental practices to choose from throughout the country, and for practices, working in-network tends to be more preferred for less expensive costs. For patients with insurance, monthly premiums will be paid each month, and for out of network expenses, patients will end up paying significantly more than in-network. There are three types of insurances including:

Preventative – Preventative dental insurance plans cover annual and semi-annual visits, and cover procedures meant to prevent diseases, including dental sealants and fluoride treatments.

Basic – Basic coverage involves treatments for extractions, fillings, root canals, and gum disease treatment, with deductibles, co-pays, and coinsurance determining the out-of-pocket expenses. These policies tend to cover at least 80% of these procedures.

Major – Major dental insurance works to cover crowns, bridges, inlays, and implants at 50%, and require the patient to pay the most out-of-pocket expenses.

While these outlines the basics, each plan can be categorized as these three and can cover only specific procedures, depending on the company. Dental insurance companies don’t typically cover cosmetic treatments; for instance, it’s essential to know what your insurance can pay for and what’s left after treatment. These insurances also have a waiting period, meaning before any standard, major work can be done, waiting periods are set to provide the insurance with guarantees for the procedure’s success and payments.

A Dentist’s Perspective on Insurance

Each practice has a different method of approaching dental insurance. As it is a daily reality, placing insurance entirely on the patient makes for bad practices, and guiding them through their insurance is what ensures great dental care more so than efficient treatment. It can be daunting on both sides, as communication with the insurer and practice can get fuzzy, confusing, and leave many patients bewildered by the results. Today’s dental industry requires practices to be more understanding and responsible for the treatment, scheduling, and insurance. To help you look for the best practice, search for these critical aspects:

  • The practice works to have co-payments paid upfront when speaking to the patient to ensure less hassle for the patient, and then work on billing the insurance company for the remaining balance
  • The practice advocates for their patients, making the most out of their insurance benefits by checking insurance during each visit, submitting the claims immediately for maximum reimbursement.
  • The practice provides brochures explaining their insurance company’s policies, what the insurance covers and doesn’t cover, and how co-payments work

To learn more about insurance processing, how practices work best to provide you with the treatments you need, and to get the most out of your dental visit, please schedule an appointment with Magnolia Dental, located in Covington, LA, for the best dental care with Dr. Ross Quartano.

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Dr. Ross Quartano, D.D.S., FAGD Magnolia Dental continuously works to achieve the highest quality dental care, providing a perfectionist approach, and gentle demeanor to our services. By incorporating the latest techniques and state-of-the-art technologies, we ensure our patients' comfort, dignity, and respect for our patients within the Covington, LA area through exceptional treatment and cleanliness.
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