You want your child to enjoy life with a healthy, cavity-free smile, but you know it comes with a cost. Fortunately, if you have dental insurance, and your child is part of your plan, you can worry less about spending more on their existing and future care. If you do not feel confident in your knowledge about dental insurance, do not worry. You can find the information you need if you just keep reading. Here are 4 essential tips to help you be better prepared to use your current plan to save on your child’s oral healthcare needs.
Accessing Your Benefits: You Must Agree to Terms
When choosing a plan with a particular insurance company, you must agree to pay the monthly premium that is required to access your available benefits. This price can vary depending on how many people are listed on your policy.
You’ll also notice there is an annual deductible you must meet before your insurance company will pay more for any services your child receives. Also, your annual maximum is the full amount that can be used in a single year.
General Benefits Breakdown: 100-80-50
If you compare various plans from your dental insurance company, you’ll find there is a similar breakdown of benefits that follows a 100-80-50 structure.
This usually means that preventive services, like dental checkups and cleanings, X-rays, fluoride treatment, etc., are covered at 100%. Dental fillings, dental crowns, pulp treatment, simple extractions, and more fall into the minor or major restorative services categories. These are likely to be covered at 50-80% of the total price.
Countdown to Expiration: Benefits Expire
Eventually, your dental insurance benefits will expire. Not all plans are the same, but many abide by the calendar year. If your child does not use all their available funds before midnight on December 31, your benefits will reset. This means you can no longer use any applied deductible toward the care your child needs for a particular year.
Instead, you’ll need to meet it once again before your insurance company agrees to pay more. Any unused funds will be returned to the insurance company.
Unexpected Injuries: Dental Savings Await
Most dental insurance companies provide one free emergency exam each year, so if your child sustains a damaged tooth or lost restoration, you may not have to pay for the urgent appointment they’ll need with their pediatric dentist.
However, the restorative care that’s required to fix the problem will incur a cost. Once insurance pays their portion, you’ll have out-of-pocket expenses, which your child’s dental team can go over during the consultation.
Knowing how to use your insurance will give you and your child the best chance to take proper care of their smile without you giving up your savings. If you have additional questions, though, make sure to reach out to your pediatric dental team for further assistance.
About the Author
Dr. Sheh Vahid is a board-certified pediatric dentist who enjoys providing exceptional services to young patients but recognizes the unexpected costs associated with oral healthcare. This is why she works closely with various PPO dental insurance plans to help individuals better afford necessary oral healthcare. If your little one is struggling with an unexpected dental injury or just needs a general exam and cleaning, visit our website or call us to find out how much you can save while your child works toward a healthier smile.