What good is dental insurance if I still owe money?

Dental Health
By:Spirit Dental
July 26, 2022




Here’s the scenario: You purchase a dental plan online, go to your dentist for a cleaning, they find a cavity (or two) and say it’ll cost around $200. What about my dental insurance? That’s with your dental insurance. Well, why am I paying for a dental plan if I still have to pay $200 for my fillings?

Good question. Let’s answer that. But first…


Dental insurance is not like health insurance

With health insurance, you pay a deductible and once that’s reached (for most plans), your coverage after is covered 100%.

Dental insurance doesn’t work this way.

Dental insurance has deductibles too, but once you reach your deductible, you’ll still be required to pay a portion of your dental bill. This is called coinsurance—you pay a portion, and your dental carrier pays a portion too.

There are also annual maximums that health insurance doesn’t have. An annual maximum is a cap on the amount your dental plan will pay per benefit year. Most dental plans are around the $1,000-$2,000 range (Spirit Pinnacle plan is $5,000 in year 3, Spirit Senior Preferred has $3,500 year 1).

 

Extra! Extra! Get your dental insurance savings here

Even though dental insurance doesn’t cover your entire bill, there are still savings available for you to use.

Dental insurance pulls different levers of savings that you should know about:

Network savings

The importance of network savings shouldn’t be overlooked when it comes to dental savings. Networks are a large group of dentists that accept lower fees to get clients that carry that particular insurance.

For instance, Spirit Dental uses the Ameritas Network which has over 130,000 dentists nationwide. If you choose any Spirit Dental plan (all Spirit plans are PPO), you can see between 25-50% savings by visiting one of these in-network dentists.

*How to check if your dentist is in-network: Simply use find a dentist and visit the Ameritas dental portal. If you see your dentist’s name on the list, they’re considered in-network, and you can use your plan benefits tomorrow. If they’re not located, you can still get benefits from a dentist out-of-network, but you’ll pay more without the network savings.

Coinsurance

The coinsurance (described above) you receive is based on the procedure you need. Dental insurance has 4 main categories of coverage: Preventive, Basic, Major and Orthodontia. Each category will have a specific percentage of coinsurance the plan will cover. It’s important to check what your plan covers with the dental service you need.

Annual maximums

But wait, you say, annual maximums are just the cap on the benefit per year, there are no savings with annual max. This is true, you won’t get additional savings with annual max. But, if annual max is the cap on your benefit, having a higher annual max will give you more savings to work with ($1,000 annual max vs $5,000 annual max).

Supplemental dental plans

Having two dental plans offers more savings than one. Let’s say you have a dental plan through your employer, you know you need an expensive dental procedure, and you’d like to pick up some additional coverage. What options are there? With Spirit Dental, these plans do not coordinate benefits. Unlike other dental plans, Spirit pays off the full claims submitted and does not look to see what any other plan is involved with saving you more money.

 

Save more when you schedule dental care

We’ve already discussed how savings work with dental insurance. But how can you take it one step further? If you’re able and if your dentist approves, schedule dental care accordingly to your dental plan.

First, figure out your needs. You visited the dentist, and the exam summary looked something like this: 2 fillings (basic category), 2 root canals (major category) & 2 crowns (major category).

Next, view your dental plan and see what savings you’ll receive until your annual max runs out.

*One of the perks of Spirit Dental is the increasing coinsurance and annual maximums. If you know you need a major category procedure, like implants, it may make sense to break up your procedures to account for more savings. With Spirit Senior Preferred, the major category goes from 10% year 1, to 50% year 2, to 65% year 3. Annual maximums also increase with our Spirit Pinnacle plan up to $5,000 in year 3.

For the dental plan’s benefit year (from the beginning of the plan’s effective date), how much can you get done within your budget?

Multiple cleanings, both fillings and one of the root canals? Do you wait for all major services until the following year when you’ve increased in coinsurance coverage? Can you do part of the procedure now (some bone grafts for a dental implant need to heal for around 4 months) and part of the procedure when your annual max resets?

Your dentist can always provide a statement of benefit for your situation that explains all costs and what your insurance will cover.

 

Your health depends on it

For most people, health and well-being rank right at the top of things they’d like to improve. It shouldn’t be a mystery that your oral health is just as important as your overall health. There are direct links to poor oral health and heart disease among others.

Visiting your dentist is like getting an oil change for your car. Your car needs annual maintenance a couple of times per year to keep the car running smoothly. Same thing with your teeth.

The dentist is much better equipped to get to the hard-to-reach spots and scrape away the sticky bacteria that your toothbrush can’t wash away.

True or false: If you have dental insurance, you’re more likely to visit the dentist. True!

And Spirit Dental offers preventive cleanings covered 100%.

Get dental insurance, see your dentist, keep your mouth in tip-top shape, stay healthy and avoid costly procedures!

 

Is dental insurance good?

Dental insurance is based on health and prevention which also helps cut costs for dental procedures. If you want to stay healthy, dental insurance helps you get to the dentist. If you want to cut down on costs, dental insurance can help there too.

With Spirit Dental, you’ll get no waiting periods, implant coverage, ortho available for families, a top network of dentists and it pairs great with Medicare.

Run your quote today and choose the plan that works for you.

If you need help choosing a plan, our Spirit Care Connect team is here to make it easy. We love talking dental insurance and guiding you to the plan that fits you best. Give us a call today: (844) 833-8440.



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