Understanding Dental Insurance

Questions To Ask When It’s Impossible to Know

First of all, and this is important, trying to navigate Dental Insurance is hard.  They make it that way on purpose!  Though this article will help to shine some light, we think the best thing to do is call us or someone you trust to help you through it.  

Still, it helps to know what questions to ask, and that’s why this article can be a good place to start.  Whether you have dental insurance, whether or not your dentist accepts it, or whether you don’t have it, this article can help to point you in the right direction.  

Let’s break it down.

How Does Dental Insurance Work?

Most dental insurance plans are structured to cover preventive care, with partial coverage for more complex procedures. Here's a quick overview of how it typically works:

• Preventive Care: Dental insurance can cover up to  100% of routine preventive services like cleanings, X-rays, and exams.

• Basic Procedures: Things like fillings, extractions, and deep cleanings often fall into this category. Dental insurance might cover 70% to 80% of the cost, leaving you responsible for the rest.

• Major Procedures: Crowns, root canals, bridges, and other extensive work may only be covered at 50% or less, meaning you’ll have higher out-of-pocket costs.

• Annual Maximums: Dental insurance plans usually have an annual maximum, which is the most the insurance company will pay toward your care in a calendar year.

Again, that’s just a big-picture view.  Every plan is different.  That’s why we suggest you reach out and let us help you figure your plan out together.

What If You Don’t Have Dental Insurance?

If you don’t have dental insurance, you’re not alone! Many people pay out of pocket for their dental care. Here are some options:

Self-Pay: What to Expect

When self-paying for dental services, it’s important to ask your dental office about any available discounts. Some practices, like ours, keep prices at the minimum level at all times, making affordable quality dental care available for all.  Other practices may provide lower rates for patients who pay at the time of service. 

Here are a few key tips:

• Ask for a Discount: Many dental offices offer 5% to 10% off the total cost for self-pay patients.

• Explore Payment Plans: Some dental offices partner with third-party financing companies that offer payment plans.

• Prioritize Preventive Care: Regular checkups and cleanings can help avoid more expensive procedures down the line, so investing in preventive care can save you money in the long run.

What Is a SuperBill?

If you're paying for dental care out-of-pocket but still want to utilize insurance benefits, a SuperBill may be helpful.

Here’s how it works:

1. You Pay Upfront: If your dental office doesn’t accept your insurance directly, you’ll pay the full cost of your treatment out-of-pocket.

2. Request a SuperBill: Your dentist can provide you with a SuperBill after your visit, which will include details such as procedure codes, dates of service, and the amount you paid.

3. Submit to Your Insurance: You can then submit the SuperBill to your insurance company, and they may reimburse you for a portion of the cost, depending on your plan's out-of-network benefits.

Still Confused?

We understand!  Reach out to us at Shiloh Dental Services, and we can help you figure your plan out in the way that makes the most sense for you.  Whether you have insurance or are navigating care without it, being proactive and informed can help you make the best financial decisions for your dental health.