dental insurance

Dental Insurance Facts

dental insurance


There are many health insurance plans available to help defray the cost of medical care. Many employers offer health insurance as part of a benefits package. But not every insurance plan covers dental needs. At Lifetime Family Dental in Gilbert, our goal is to provide excellent dental care without stress. We know that some insurance plans are confusing when it comes to understanding what is covered under dental insurance. Here are some things to consider when you plan on using or purchasing dental insurance:

How much is covered?

Dental insurance rarely covers the cost of everything. Many plans will claim to cover 80%-100% of dental costs, but you need to be aware of a few exceptions and exemptions. Most will cover routine cleaning and exams, but not root canals, for instance. It pays to understand the “fine print” so you won’t get sticker shock before the anesthesia has worn off. In reality, dental insurance plans are meant to help, rather than cover everything. Typically, a dental plan will cover 40%-60% of your dental costs.

Employer Plans

When you examine your employer’s benefit plan, you may discover that you will pay more out of pocket than you will through private insurance. Your benefits will only amount to what your employer puts into the plan. The less the employer pays, the less your benefits will be. You do have the option of purchasing private or supplemental insurance, however. If you or a family member is facing a non-standard procedure, this kind of insurance can help you manage costs.

Types of Dental Insurance Plans

There are generally three options when it comes to dental insurance plans:

  • Preferred Provider Organization: Like a health insurance PPO, this plan requires you to use a dentist who is a member of the organization. If you use a non-affiliated dentist, your out of pocket costs will be higher.
  • Dental Health Maintenance Organization: A DHMO has a network of dentists who accept the plan. They charge a set copay, and you cannot use the insurance outside of the network.
  • Discount plan: Rather than accepting an outside insurance plan, these dental services are provided with a discount. At Lifetime Family Dental, we offer a VIP Plan that is a popular and cost effective alternative to dental insurance.

Coverage Guidelines

Generally, dental policies cover part of the cost of preventative care, restorative care, and extractions. There may be restrictions on orthodontics, periodontics, and dentures or implants. Most plans will cover 100% of preventative care costs, such as cleaning and examinations. They will typically cover 80% of basic procedures like fillings and extractions. For more extensive procedures, they may only cover 50% of the costs.

There are caps on what an insurance plan will pay over a year. That cap can be pretty low. Many PPOs set the maximum at $1500. You pay out-of-pocket for everything exceeding that. Crowns, root canals, and wisdom tooth extractions can be expensive and easily exceed the cap. It pays to know exactly what your plan covers and what it doesn’t.



What about Lifetime Family Dental?

We have already mentioned our discount VIP Plan. The cost of the VIP PLAN is $150 per person per year. To add a dependent under the age of 15 is $75. This plan entitles you to two routine cleanings, X-rays and two exams per year at no additional charge. You will also receive up to 30% discount on additional dental services provided by Dr. Norton. We also participate in most PPO plans.

If you have no insurance at all, you can apply for financing through CareCredit. They have a variety of low minimum monthly payment plans with no interest short term and low interest long term dental financing. Our bottom line at Lifetime Family Dental is to offer the best in dental care. Understanding your dental insurance will help us give you the best service and maximum peace of mind. Call today for an appointment or to discuss your financing needs. We are here for you!



Images used under creative commons license (Commerical Use) 05/06/2020 Image by Jenny Friedrichs from Pixabay