How Much Do I Have To Pay?
That will all depend on the plan you choose.
There are many variations so it’s always important to know your plan details.
Some plans set annual deductibles, limit plan spending, cap dollar amounts, and limit the number of visits allowed in a benefit year.
Dental plans often do not cover every dental procedure, however, for the basics including regular check-ups, x-rays, hygiene (cleaning), fillings, root canals and extractions will usually be partially paid out.
The ratio for insurance payments in minor procedures is typically 80% -20%.
This means that an insurer is likely to pay about 80% of the treatment costs according to their own fee guide, leaving the 20 % an “out of pocket “expense for the patient.
For treatment deemed major, such as crowns and bridges the ratio is more likely to be 50% – 50% of the insurer’s fees.
It is important to understand that the majority of dental clinics may be using their own fees for procedures and not the ones set by your insurance company, resulting in a higher co-payment for the patient.
Your Dental Clinic can also provide you with a predetermination of costs.
A predetermination is a request sent to your insurer asking for coverage and estimated reimbursement details.
This gives the patient an idea of what will be covered and what will be “out of pocket”.
However this is just an estimate and may differ when the time of treatment happens, it is a good resource to use when wanting to know what your benefits will help you with.