Dental Insurance 101: Understanding Your Policy’s Terminology

Hands on a keyboard below a computer screen showing dental insurance information.

At Paris Mountain Dental, we understand that dental insurance can be confusing. Not only is it completely different from medical insurance, but policies can use strange terminology that can leave you scratching your head. Today, we want to shed some light on dental insurance so you can maximize your dental benefits.

How Are Dental HMOs & PPOs Different?

The first step in understanding your dental insurance is learning what type of plan you have.

PPO Plans

If you have a PPO, you’ll probably have higher out-of-pocket costs for treatment. On the plus side, you’ll have the flexibility to select your primary dentist. You can also see dental specialists without needing a referral from your primary provider.

HMO Plans

HMO plans are usually lower cost, with a focus on preventive care. They will incentivize you to get regular dental cleanings and exams. However, you will have less choice when selecting your dentist, and you’ll need a referral to any specialist.

Does It Matter If a Provider is “Out of Network”?

With medical plans, a provider that is out of network usually will not be covered. With dental plans, this may not be the case. Some plans still cover out of network providers, but at a lower percentage of the treatment. Paris Mountain Dental accepts both in network and out of network insurance providers.

What Type of Treatments Does Dental Insurance Cover?

Most dental plans provide different levels of coverage depending on the type of treatment. For example, routine preventive care like dental cleanings, exams, and X-rays are typically fully covered. Basic procedures like fillings and root canals are generally covered at around 80 percent. Other major procedures, like crowns or bridges, may be covered at around 50 percent.

Insurance Help in Travelers Rest

Still can’t make sense of your dental plan? Paris Mountain Dental recommends that all of our patients read through their dental plans to make sure they’re taking advantage of all their benefits. However, we know that dental plans can be hard to understand. Our team is always available to answer questions about your plan and to help you strategize to maximize your benefits.

Paris Mountain Dental Savers Plan

If you don’t have dental insurance, please look into our Dental Savers Plan! Members pay an annual fee for the discount plan which includes preventive services and discounts on other services. You can join as an individual or pay for a family membership. The Dental Savers Plan eliminates the hassles and confusion associated with dental insurance. To ask us any questions or schedule an appointment, call us today!

We can help you navigate your insurance coverage!

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