{{ name }}

Understanding Dental Insurance

Understanding Dental Insurance

You don’t have dental insurance. You have dental benefits.
Understand your benefits and avoid costly mistakes.


Dental insurance serves a different purpose than medical insurance. Understanding key
differences between how they both work can help you get the most out of your dental benefits
and avoid costly mistakes.

1. Dental insurance is a discount plan for preventative care. Medical insurance is a safety net for big, unexpected costs.

2. Dental plans provide a limited yearly benefit. Medical plans limit your costs with out of pocket maximums.

  • Dental plans usually have an annual benefit maximum of $1000-$2000. Any costs

exceeding this yearly maximum benefit become the responsibility of the patient.

3. Dental plans share costs between the insurance company, the patient and the dental clinic.

  • Dental plans frequently follow a 100-80-50 rule

    • 100% coverage for preventative care (cleanings, exams, xrays, fluoride)

    • 80% coverage on basic procedures (filings, crowns on baby teeth)

    • 50% major treatment (white fillings sometime fall into this category)

  • Dental plans provide discounts at participating dental offices

4. For both, annual deductibles may apply.

Coordination of Benefits

When a patient has more than one dental policy, insurance companies will determine which
insurance pays first using an industry wide standard.

*Insurance companies will not pay claims without this coordination of benefits.