Dental insurance is great for cleanings and checkups. However, when it comes to bigger procedures, it might not pick up the tab. Understanding what is not covered can help you avoid costly surprises and plan your care more wisely.
What is covered?
Dental Insurance is designed to help with preventative care and reduce your out-of-pocket costs for more extensive procedures. Most dental plans follow a 100-80-50 coverage model; however, it can depend on your unique needs and coverage limits.
Dental insurance typically covers:
- 100% for preventative dental care such as routine cleanings, oral exams, and X-rays.
- 80% for restorative care such as filings, extractions, and some periodontal care.
- 50% for major dental care such as crowns, dentures, and root canals.
Does dental insurance cover orthodontics?
Orthodontic care is a specific type of dental service that assists with correcting or readjusting tooth alignment. It is typically not included in standard adult dental plans. However, some plans may offer orthodontic coverage for children and teens under 18. Orthodontics can be included in dental plans, but it may be through a separate add-on rider.
What is not covered?
Dental insurance is not a one-size-fits-all kind of policy. Most dental plans do not cover:
- Cosmetic procedures such as whitening, veneers, and bonding. These procedures are often done for aesthetic reasons and not to address oral health issues.
- Dental implants are typically excluded from dental plans, but some plans may offer limited reimbursement.
- Pre-existing conditions are typically not covered. For example, if you need a crown on a tooth that was diagnosed before your policy started, coverage might be denied.
Let’s talk
The best smile starts with knowing what is actually covered. Contact one of our experienced Avery Hall agents today at 410-742-5111 for our Salisbury, 410-822-7300 for Easton, and 302-536-9470 for our Selbyville office.