How Dental Insurance Works

What You Need to Know About Dental Insurance

Patients should always know the following three items:

  1. Annual Maximum Benefit (Typical range: $1,000 – $2,500) – This is the most money that your insurance will pay in a given year.
  2. Refresh Date: Usually Jan 1st of every year but patients need to verify as it can be any date. On this day, your Annual Maximum Benefit will “Refresh” meaning that you start each year with a new $1,000. It is very important to realize that Annual Benefits do not “roll over” or accumulate. Any benefit not used in the prior year disappears forever.
  3. Co-pays- This is the portion that your insurance company will NOT pay and is your responsibility. Dentistry is divided into three categories with each covered by insurance at a different percentage.
  • Preventive – Cleanings, X-rays and Exams – usually covered around 100%
  • Basic – Fillings and extractions – usually covered around 75%.
  • Major – Crowns, dentures, implants, etc. – usually covered around 50%.

Tyler Davis DDS base patient treatment plans to reflect individual coverage and needs. A patient with no Major treatment needs should not be paying large premiums for Major coverage as they will never realize that benefit, whereas a patient who requires Major work (e.g. Crowns, bridges, dentures) will benefit from a higher Annual Max and higher coverage on Co-Pays. Most all insurance plans cover cleanings every 6 months and X-rays every year with little or no Co-Pay, so patients will lose out on free benefit by allowing the Refresh Date to hit without being seen by the staff.

We Help You Save Time & Money

By knowing your specific plan and the benefits provided, you as the patient will save time and money as well as making sure they have the best coverage possible. Please ask Dr. Davis any questions that you might have, we can review your plan and discuss the options that are available to you.

We file insurance claims, regardless of your Insurance Company, on your behalf – saving you valuable time and money.