If you are fairly new to your dental insurance policy, you might have come across some unfamiliar terms. For example, your plan probably has a deductible. What does that mean? Read this guide to dental insurance deductibles to learn everything you should know about this aspect of your benefits.
What Is a Deductible?
A deductible is simply the amount of money you must pay to your dentist before your dental insurance coverage kicks in. For example, let’s say that you need a small filling. Most insurance plans cover 80% of the cost of fillings after the deductible has been met. Therefore, if your filling will cost $300 and your deductible is $50, you will pay $50 plus 20% of the remaining cost of the service. Your total out of pocket will be $100.
You only have to pay your deductible once a year. In the above scenario, if your deductible had already been met earlier in the year, you would have paid just 20% of the $300 total.
Individual vs. Family Deductibles
If you have multiple family members on your dental insurance policy, you may have a family deductible as well as an individual one. For example, each member of your family may have a $50 deductible, and the family deductible may be $150.
If three members of your family pay their $50, that will satisfy the $150 deductible. The remaining beneficiaries of your policy will not have to worry about paying any deductible at all.
Some Services Do Not Require a Deductible
Usually, insurance companies require a deductible for restorative dental services, like fillings, crowns, and gum disease treatment. Often, though, they waive the deductible for preventive services, including cleanings and checkups.
Therefore, if you policy covers 100% of the cost of preventive care, you may have to pay absolutely nothing out of pocket for your twice-yearly cleanings and checkups.
Not All Policies Have a Deductible
There are a few different types of dental insurance plans. PPO policies, which allow you to visit any dentist, usually do have a deductible. HMO plans, on the other hand, are typically deductible-free. The disadvantage of HMO plans is that you may have a very limited selection of dentists to choose from.
Do you still have questions about deductibles? Your local dental team or your insurance company may be able to help!
Meet the Practice
Here at My Dentist, Dr. Stephanie Flinchum and our team are proud to accept many forms of dental insurance; we are even in-network with several popular policies. If you would like to learn how we can help you take full advantage of your policy, get in touch with our Tulsa office at 918-949-4450.