Dental insurance is an investment in your oral health. Your premiums give you access to a nationwide network of dental professionals to keep your teeth and gums healthy. Your insurance will cover some of the costs for preventive dentistry and medically necessary services to lower the amount you pay out-of-pocket. Your dental insurance will recommend choosing a dentist that’s in their network, but you still have the freedom to choose an out-of-network location. However, here are a few things you should know before visiting an out-of-network dentist.
How Dental Insurance Works
Dental insurance focuses on prevention to stop common oral health issues from occurring. This prevents needing costly dental work later to lower your overall oral health expenses. However, if a problem occurs, your dental insurance will cover some of the expenses after meeting your annual deductible. You can use your yearly allowance for medically necessary services, like fillings, dental crowns, dentures, and tooth extractions.
At the end of the year, your benefits will reset. You will lose anything you do not use and nothing will carry over. With less than 3% of Americans meeting or exceeding their annual limits, you don’t want to throw money away. Instead, use your benefits to achieve your best smile by visiting a dentist in your network.
In-Network VS Out-of-Network Dentist
Dental insurance companies recommend choosing in-network dentists to enjoy more coverage. They have pre-negotiated rates with preferred dentists to put a limit on out-of-pocket costs for policyholders. Although every situation differs, your benefits with an in-network dentist may include:
- 100% coverage for preventive dentistry.
- 80% coverage for basic dental work.
- 50% of major dental services.
You can use your insurance at an out-of-network dentist, but there’s no limit on the amount they can charge you for services. Your insurance may pay for some treatments, but at a much lower rate than when choosing an in-network dentist. In addition, you may need to pay for the services at the time of treatment, instead of being billed after your insurance company pays their responsible portion of the expenses.
Maximize Your Dental Insurance
An out-of-network dentist allows you the freedom to choose your dental practice and services that may not typically be covered by your insurance. However, be prepared to pay more out-of-pocket. An in-network dentist is the most affordable choice overall to maximize your coverage to invest in healthy teeth and gums. Your dentist will work on your behalf with your dental insurance to utilize your benefits fully.
About Dr. Rajiv Shekhadiya
Dr. Shekhadiya is a graduate of New York University, achieving his Doctor of Dental Surgery degree. Dr. Shekhadiya is a proud member of many professional organizations, including the American Dental Association. He accepts various dental insurance plans and offers flexible financial solutions to keep a healthy smile within everyone’s budget. Request an appointment through his website or call his office at (469) 607-8009.