Dental Insurance 101

A lot of Albertans struggle to understand their dental insurance and for good reason. It doesn’t really act like insurance the same way home or life insurance does. Instead, it’s better to think of dental insurance like a pre-paid plan. Similar to a pre-paid cell phone, there will be certain rates for certain procedures, and your dental plan will lay out how much they’ll cover, and at what point you need to start paying. This can lead to a ton of confusion about what 100% dental coverage means because often it’s not nearly as straightforward as fully inclusive coverage.

You May Have Used up All of Your Coverage Already.

Often we meet patients who thought they had 100% coverage on a dental procedure like a cleaning or a root canal but actually don’t when the bill goes through. For these patients, we always suggest seeing if there are any exceptions or an asterisks by that 100% coverage. Sometimes patients will have a cleaning 100% covered — but only one cleaning and only every two years. Other times we’ll meet patients with 100% coverage on fillings, but only to a maximum of $300. What this means is if all your fillings come in under $300 for that year, you will have 100% coverage, but if you have numerous fillings and the final cost is $400, you’ll need to pay the extra $100. These sorts of asterisks make it important to carefully go through any dental plan you’re considering.

Certain Procedures May Not be Covered At All.

If you have 100% coverage on all preventative care, that’s great! Unfortunately, it won’t help pay for your filling if you already have a cavity. It’s important to look at what is and what isn’t included in your dental plan. And remember that many benefits may take a while before you can actually access them. For example, many dental insurers require you pay for a plan which includes orthodontic coverage for at least 6 months before you can use those benefits.

Deductible.

Some plans with high coverage may require that you pay a deductible. This is usually a small fee of $50 or $100 in order to access certain benefits. Think of it sort of like a down payment. You pay the first $50 of your dental bill, the insurance company pays the rest of the bill, and you pay the insurance company a monthly fee.

While we may call it dental insurance, it may be better to think of your coverage as pre-paid dental care. That’s why we encourage all of our patients to try and use up all of their benefits before the year is over. After all, you’ve been paying for the coverage, so if you don’t put it to good use, it’s just money in your insurers pocket with no benefit to your smile! If you want to squeeze the last bit of benefits from your insurance company, contact Metro Dental today. We’d be happy to try and squeeze you in before the new year.