Sign Up for Our Limited Time $99 New Patient Offer

The Difference Between Medical and Dental Insurance

August 4, 2024

Dental insurance form, eyeglasses, molar, and calculator on teal backgroundMedical and dental insurance give you coverage to support optimal wellness. However, there are differences between the two. Dental insurance works differently than your medical coverage. It’s designed to keep your teeth and gums healthy for minimal out-of-pocket expenses. Here’s what you need to know about your dental coverage to keep your mouth healthy.

Medical Insurance VS. Dental Insurance 

Your premiums give you access to a nationwide network of dental professionals offering comprehensive services. Dental insurance focuses on prevention to stop common oral health issues to avoid needing costly dental work later. Researchers have found that every $1 of prevention can save up to $50 on restorative and emergency fees. You are given an annual allowance to use toward the cost of dental services after meeting your yearly deductible.

Understanding Your Dental Benefits

Every insurance policy differs, but most follow the same basic coverage, which includes:

Preventive Dentistry

You can benefit from 100% coverage for preventive services for a co-payment. You can visit your dentist every 6 months for a cleaning and checkup to keep your teeth and gums healthy. Your policy may cover several preventive services, including fluoride varnish.

Basic Dental Services

If a complication occurs, like a cavity, your dental insurance will pay up to 80% of the expenses for basic dental services, like fillings. You must meet your deductible before your benefits will kick in.

Major Dental Services

Major dental services, like tooth extractions, dentures, and advanced restorative treatments can be covered by 50% until you reach your yearly limit.

Some policies also offer orthodontics, emergency dentistry, and other services.

In-Network VS. Out-of-Network Dentist

Your dental insurance will recommend choosing a dentist in their network. They have pre-negotiated rates with select dental practices for certain treatments to lower the amount you will pay out of pocket. You can enjoy the freedom of choosing the services, specialists, and dentists you want with an out-of-network provider. You can still use your insurance, but you may be responsible for a larger portion of the fees.

Dental Benefits Reset Annually

Your dental insurance benefits do not last forever. Your policy resets at the end of the calendar year. You will lose anything you have not used. It will not accumulate, and you aren’t reimbursed for your premiums or deductibles.

Less than 3% of Americans meet or exceed their annual limits, which results in billions of dollars lost in unused dental benefits every year. You don’t have to throw money down the drain. Your dental insurance gives you the opportunity to improve your oral health without spending your life’s savings.

Your dentist will work on your behalf with your dental insurance to maximize your annual coverage. With your oral health and general wellness connected, you can invest in a healthy mouth and body for minimal expense.

About Dr. Katie Carroll

Dr. Carroll is a talented dentist who earned her dental degree from Case Western Reserve University. She continues her training regularly to provide the most current solutions in dentistry. She accepts many dental insurances to keep dentistry affordable. Schedule an appointment through her website or call her office at (614) 739-9320.