August 10, 2021
Does your dental insurance policy cover your son or daughter? Maximizing your little one’s insurance coverage is an important way to set them up for a lifetime of great oral health. While dental insurance may seem confusing or overwhelming at times, understanding a few key basics can help you make important decisions for your family in confidence. Here are five simple but effective tips to help you make the most of your dental insurance and keep your child’s smile healthy as it grows.
1.) Keep an Eye on Your Deductible
A “deductible” is how much you’ll be responsible for paying out of pocket for dental treatments before your dental insurance plan begins to cover them. Generally, plan with lower deductibles have lower annual maximums, while higher deductibles often have higher annual maximums. Because of this, it may sometimes be better to schedule treatments around this information, which your dentist will help with.
2.) Don’t Let Your Annual Maximum Go to Waste
An “annual maximum” is how much your dental insurance company is willing to pay for your (or your child’s) dental care after you’ve reached your deductible. This limit is a certain dollar amount, and once the cost of your care passes it, you’ll be responsible for paying the balance. Unfortunately, whatever you don’t use from your annual maximum doesn’t roll over to your next period of coverage. If your child needs dental treatment and you’ve already met your deductible or are close to doing so, schedule their appointment before your plan renews and your maximum expires.
3.) Remember the 100-80-50 Rule
It can be difficult to keep up with all that your dental insurance plan does or does not include and at what percent. While every policy is different and you should know the exact details of your unique plan, most dental treatments follow the 100-80-50 rule:
- Preventive care like checkups and cleanings typically receive 90-100% insurance coverage.
- Basic treatments including fillings and root canals often get 60-80% coverage
- Major restorations like dental crowns usually get 50% coverage or less
4.) Ask for a Pre-Determination of Benefits
Along with the 100-80-50 rule, asking for a pre-determination of benefits will help you predict how much your child’s dental care will cost. Your dental insurance will process the estimate and send you a statement that breaks down what you can expect your plan to cover and by how much. This will help you avoid any unpleasant surprises when it’s time to pay for services.
5.) Take Advantage of Dental Checkups
As you can see from the 100-80-50 rule, insurance coverage tends to lean on the side of prevention. And for good reason! Most all dental problems that require major treatments or restorations can be prevented with good oral hygiene and regular checkups. Take advantage of the preventive care that your plan covers to avoid complicated, painful, and expensive dental issues in the future.
If you have more questions or concerns about your child’s dental insurance coverage, don’t hesitate to talk to your dentist and their financial team. They’ll be happy to help you maximize your benefits and minimize your out-of-pocket expenses while simultaneously keeping your child’s smile healthy.
About the Practice
Dr. Angelica Rohner is a Board-Certified pediatric dentist with a heart for serving the growing smiles of Birmingham and the surrounding communities. She and her talented team go above and beyond to make every part of oral healthcare as pleasant as possible, including the financial aspect. Her office is in-network with BCBS of Alabama, Southland, Delta Dental, MetLife, United Concordia, Guardian, and Cigna Dental. If you have more questions about dental insurance, she can be contacted online or at (205) 870-0892.
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