How Can I Make The Most Of My Dental Insurance Benefits?

If you want to get dental care in Oak Park and maximize your insurance coverage, you may not know where to start. In this quick guide from the office of Wesley C. Wise, DDS & Assoc., we’ll discuss a few things you should know in order to get more from your dental insurance policy. 

1. It’s Best To Get A Checkup Every Six Months

Almost all dental insurance plans will cover 100% of the cost of two oral exams and teeth cleanings per year, as well as a set of annual x-rays. Some plans also cover additional preventive care like deep cleanings for gum disease, but this varies based on your insurer. 

2. Choosing An In-Network Dentist Will Save You Money

No matter what type of plan you have, choosing an in-network dentist will save you money, because your dental insurance will pay for more of your treatment. 

At our office, Dr. Wise has partnered with many different providers including Aetna, BCBS, Connection Dental, Cigna, Delta Dental, UHC, and more. Give us a call at (708) 524-0330 to see if we work with your insurer in Oak Park. 

3. Most Dental Plans Follow The Same 100-80-50 Coverage Structure

While not all plans follow this fee structure, most do. The 100-80-50 structure refers to how much your insurer pays for each type of dental treatment, as follows:

  • Your insurer will pay for 100% of preventive treatments, like twice-yearly cleanings and oral exams
  • Your insurer will pay for 80% of basic treatments, like root canals and fillings
  • Your insurer will pay for 50% of major treatments, like crowns, bridges, and dentures

The remaining percentage, if applicable, will be paid by you out-of-pocket. This is yet another great reason to prioritize preventive care and at-home oral hygiene. You can save a lot of money by avoiding out-of-pocket dental expenses. 

4. Your Plan Probably Has A Yearly Deductible And Annual Maximum 

Most dental plans have a deductible, similar to a medical insurance plan. This is usually between $25 and $250. Once you pay this amount out of pocket, your insurer will begin paying toward your dental care.

However, dental plans also have an annual maximum benefit, typically between $1,000 and $2,000. Once you exceed this benefit, your plan will no longer pay for your care. 

The deductible and annual benefit usually both reset on January 1st every year. So, in some cases, it may be possible for Dr. Wise to coordinate your care in order to avoid exceeding your maximum benefit. This ensures you get the most from your insurance.

Get The Dental Care You Need In Oak Park From Dr. Wesley Wise

We hope the above tips can help you make the most of your insurance while getting care from Dr. Wise. And even if you’re not insured, we’re here to help at the office of Wesley C. Wise, DDS & Assoc. 

We offer payment plans like CareCredit, as well as cash discounts for up-front payment, and we do our best to keep our prices reasonable so that money is not an issue when it comes to high-quality dental care. Contact us online or give us a call at (708) 524-0330 to schedule your appointment.