Dental insurance can be a helpful tool for defraying the cost of dental care. However, it does have several limitations that are important for patients to understand. Here's what you should know.
How Dental Insurance Limits Your Care
Most dental insurance plans have annual maximums that they will pay within a year. This is typically around $1000 to $2000. Unfortunately, if you need major treatment like a crown or dental implant, this doesn't cover the cost. Most insurance plans will also only pay a percentage of the treatment fee, leaving you with an out-of-pocket expense.
Some dental insurance plans also have waiting periods for major care, like a crown. So if you have an emergency that requires more complex treatment within that waiting period, there may not be coverage.
Dental insurance typically doesn't cover treatment like dental implants. It also won't cover cosmetic treatment that it considers elective. So many patients are finding dental insurance to be very limiting and not as beneficial for their needs as they would like or need it to be.
What It Means When a Dentist Is Out of Network
Dental insurance plans also come with network limitations. When a dentist is in-network, they agree to set fees, which can restrict the materials they use and the level of treatment they can provide. If a dentist is out of network, some plans offer no coverage at all, while others provide a reduced level of coverage.
You may or may not have coverage with an out-of-network dentist depending on your particular insurance plan.
What to Consider Beyond Insurance Coverage When Choosing a Dentist
Most patients prefer to work with a dentist who provides exceptional care using high-quality materials. So, many patients are switching to in-office membership plans to help defray the cost of their dental care.
At Pryor Dental, we have a dental membership plan that helps patients stay on track with preventive care and helps defray the cost if they need more complex treatment. Contact your dentist in Winston-Salem, NC, for more information on our dental membership plan.