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4 Terms You Need to Know To Maximize Your Dental Insurance Benefits

November 12, 2019

Filed under: Uncategorized — jldental @ 3:09 pm
stack of savings with the numbers "2020" sitting on top

Did you know that at the beginning of every year, your dental insurance policy resets? When this happens, any benefits that you haven’t used will fall back into the pockets of your dental insurance company instead of being used to optimize your oral health. If the thought of navigating the basics of your plan makes you stressed out, your dentist in Arnold highlights four terms you should know to maximize your benefits below.

Annual Deductible

Each year, your dental insurance provider will set a deductible, which is a set amount of fees that you’ll be required to pay out of your own pocket before your benefits will begin covering the cost of your visits. The average deductible is $50, but once it has been paid, you won’t have to cover the cost again until your policy restarts on January 1st. To get the most out of your deductible, don’t let it go to waste by getting all of the treatments you need before the beginning of the year rolls around.  


Most dental insurance providers operate under a 100-80-50 structure. All this means is that they cover 100 percent of preventive dental care, 80 percent of basic treatments such as cavity fillings, and 50 percent of major procedures such as root canal therapy. When you get oral health problems taken care of while they don’t require extensive or invasive procedures, you’ll be able to save yourself from the burden of steep out-of-pocket costs.

Preventive Dental Care

Your dental insurance plan most likely covers the cost of two checkups and cleanings in a 12-month span of time. That’s because your insurance provider wants to encourage you to be proactive about your dental health and avoid serious issues such as tooth infections and severe cavities. Also, by visiting your dentist regularly, you’ll be increasing your chances of diagnosing and treating issues early, before they have a chance to impact your overall wellbeing.

Yearly Maximum

Each year, your dental insurance provider will set a capped amount that they will cover for your treatments and procedures, called a maximum. The average maximum is anywhere from $1,000 to $1,500 depending on your unique plan, so it’s best to contact your provider directly to find out. Because your insurance policy restarts on January 1st, any unused maximum will be pocketed by your provider instead of being used to optimize your oral health. That’s why to get the most out of your benefits, it’s best to either meet or exceed this annual amount before the year is over.

If you have any questions about how your dental insurance policy works, a great place to start is to contact your dentist’s office an ask them if they can help you navigate your plan and coverage. With the right team by your side, learning about this complicated topic can be easier than ever. They can also provide you with tips and tricks to maximize your benefits!

About the Author

Dr. Laura Mears has been working in dentistry for 14 years. She has completed advanced training in a variety of dental topics, including cosmetic dentistry, dental implants, endodontics, oral surgery, and many more. This allows her to provide each of her patients with the high-quality comprehensive dental care that they deserve. She is also an in-network provider with a most major insurance plans. For questions or to schedule a routine checkup and cleaning before your benefits restart on January 1st, visit JL Dental’s website or call 636-464-6668.

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