Dental insurance can potentially help you save a lot of money on your oral healthcare, but it’s important to make sure that you understand all the details of your plan. For example, many dental insurance plans come with a deductible. What exactly does this term mean? And how will it affect the amount you need to pay for treatment out of pocket? The answers can be found below.
What Exactly is a Deductible?
Simply put, the deductible is the amount that you need to pay before your dental insurance company covers any treatments. You only need to meet your deductible once to take advantage of your current benefits. After that, your insurance company will start partially covering your dental expenses until your plan resets or you use up your annual maximum.
What are Family Deductibles and Individual Deductibles?
If you have a family dental insurance plan, there may be a shared family deductible as well as an individual deductible for each person covered by the plan. Paying an individual deductible counts toward the family deductible.
For example, say that your plan has a family deductible of $100 and an individual deductible of $50. Once you have met your individual deductible of $50, insurance coverage will kick in for your own dental treatments. And when two members have met their $50 individual deductibles, the $100 family deductible will be satisfied; this means your insurance company will now help cover dental care for everyone included in the plan regardless of whether they have met their individual deductibles.
Does Every Dental Insurance Plan Have a Deductible?
The vast majority of dental insurance plans do require their enrollees to pay a deductible, but this is not universal. In particular, PPO dental insurance plans often involve deductibles while HMO plans don’t. However, many people find that PPOs are worth the tradeoff of a deductible because they also offer more freedom when choosing a dentist; HMOs will only cover treatments performed by an in-network provider.
Are There Any Services That Your Deductible Doesn’t Apply To?
There are certain services that some dental insurance companies are willing to pay for even if you have yet to meet your deductible for the year. This is often the case for preventive care; you may not have to worry about your deductible when it comes to regular checkups and cleanings. This makes it easier to fit these important services into your budget.
Hopefully, the information above can help you feel like you have a better grasp of what a deductible is and what it means for your dental insurance coverage. Remember that you can always reach out to your dental insurance carrier if there’s anything you don’t understand. The team at your dentist’s office may also be able to clarify the details of your plan.
About the Author
Dr. David Thomas went to the University of Pittsburgh for his dental education. He cares about forming trusting relationships with his patients and helping them make the right decisions for their smiles. His practice, Seahurst Park Dentistry of Burien, is in-network with Aetna, Cigna, and other popular dental insurance plans. To schedule a consultation with Dr. Thomas, visit our website or call (206) 244-4622.
