How Can I Make The Most Of My Dental Insurance Coverage? 

If you’re paying a monthly premium for dental insurance coverage, you probably want to make sure you’re getting the most from your policy. Need some tips and advice? In this blog, Scarsdale Smiles will discuss a few things you should do to get more from your dental insurance coverage. 

1. Choose An In-Network Dentist For Your Care

Choosing an in-network dentist will reduce your cost of care if you have a PPO, and at Scarsdale Smiles, we accept almost all PPO plans. Some of the common plans our patients have include Aetna, Anthem, Guardian, Delta Dental, United HealthCare, and more. Call us at (914) 723-1186 to make sure we accept your policy. 

2. Get Two Teeth Cleanings And Oral Exams Each Year

If you have dental insurance, it probably covers 100% of the cost of two preventive dental appointments per year. So make the most of this coverage by seeing Dr. Cox every six months for checkup. This will keep your mouth healthy and help you maximize your benefits. 

3. Know The 100-80-50 Fee Structure And If It Applies To Your Plan

Most, though not all, dental plans use what’s known as a 100-80-50 fee structure. In this type of dental plan, 100% of the cost of preventive care like oral exams and teeth cleanings will be  covered by your plan.

However, this is not true of “basic” dental care and “major” dental care, which are covered at 80% and 50%, respectively. Basic care includes things like fillings and root canals, while major dental care includes things like oral surgery, dentures, and crowns. 

What this means is that you’ll pay less overall for dental care if you keep your mouth healthy. Focusing on preventive care helps you avoid costly treatments that may only be covered at 50% by your insurance. 

4. Plan Around Your Yearly Deductible & Annual Maximum 

Your plan likely has a yearly deductible of between $25 and $250. Your insurance plan will not pay out until you reach this deductible within a calendar year. Then, it will cover your treatment.

However, it will only pay out until you hit your annual maximum, which is usually between $1,000 and $2,000. Once you reach this limit, you will pay out-of-pocket until your benefits reset.

In some cases, you can work with your dentist to plan around this. For example, you could schedule urgent treatment for November or December of one year, and then get a less-important procedure done in January, since most dental plans “reset” on January 1st. 

5. Choose Our In-House Plan If You’re Uninsured

Great dental care isn’t just for people who have dental insurance. At Scarsdale Smiles, we offer an in-house dental plan for $479 per year. This includes:

  • Two hygiene or perio maintenance appointments
  • Two exams and oral cancer screenings
  • Two teeth cleanings
  • All recommended x-rays
  • 1 emergency visit
  • 20% off all other treatments at our office

Contact Scarsdale Smiles To Get The Dental Care You Need In Scarsdale 

Dr. Alex Cox is an experienced family dentist in Scarsdale, and treats patients of all ages with gentle, informative care. With options available for insured and uninsured patients, we do our best to keep your treatment affordable. Contact us online or call at (914) 723-1186 to schedule an appointment now.