When enrolling in a dental insurance plan, there’s a good chance you’ve noticed unfamiliar terminology. Although “deductible” may not be completely foreign to you, knowing why it exists and how it’s used can cause uncertainty. Before you start trying to investigate on your own, only to be led to various thoughts, opinions, and suggestions, hear from a local dentist who can explain more about your dental insurance deductible and the best way to meet it each year.
What is a Deductible?
You will find that most insurance companies (i.e., dental, health, car, etc.) have plans that include a deductible. This is the amount you are expected to pay out of pocket each year before your insurer will agree to pay more for the services you receive. When it comes to dental insurance, deductibles tend to be low (i.e., $50) but must be met before your benefits can be used.
Also, because most dental insurance plans are good for one calendar year, your deductible will reset to $0 on January 1, which means you’ll be required to meet it each year.
How Does a Deductible Work?
Depending on the type of plan you have, your deductible may be used toward preventive dental checkups and cleanings or not. If these twice-yearly appointments are the only times you see your dentist and they do not account for a deductible, you won’t be required to pay anything toward it. However, if you require minor restorative care, you’ll first need to pay your deductible before the insurance company agrees to pay a portion or all of the remaining balance. If you have multiple treatments performed in a single calendar year, you’ll only need to pay your deductible once (if the cost of the service meets the full amount of the deductible).
Which Dental Services Are Put Toward My Deductible?
The answer depends on the type of dental insurance plan you have. While some allow your deductible to be met using diagnostic and preventive care, others do not. One important factor you’ll need to identify either independently or with the help of your dental team is if your deductible is subject to treatments performed by an in-network dentist.
Which Dental Plans Don’t Require a Deductible?
As you research the type of dental insurance plan you prefer, make sure to understand the difference between a PPO (Dental Preferred Provider Organizations) and a DHMO (Dental Health Maintenance Organizations). With a PPO plan, you can choose which dentist you want to see for available services while also enjoying the benefits of full or partial coverage by your insurance company. While most PPO plans do have a deductible you must meet, a DHMO usually does not have them, but your choices for dental care are much more limited.
Now that you know more about dental insurance deductibles, you can better plan for any expenses during your next visit. If you still have questions, do not hesitate to ask your dental team when you arrive.
About the Practice
The dental team at Indy Dental Group wants you to get the most out of your dental insurance plan, which is why we work to identify ways you can save. By helping you maximize your benefits, we can help you avoid high out-of-pocket costs while ensuring you get the care you need. If you’re unsure how to navigate your policy or need help filing a claim, contact us at (317) 846-6125.