How Does Dental Insurance Work?  

How Does Dental Insurance Work?  

Getting the most out of your dental insurance plan starts with understanding how it works, and what’s covered. With the right information, you can be equipped to make smart decisions about your oral health care — and save money while you’re at it!  

Who Does Dental Insurance Pay? Me or the Dentist?  

Your dental insurance benefits kick in and “reimburse” what’s owed after your services are rendered. That’s why some people receive a bill from their dentist 4-6 weeks later, should their carrier reject the claim or decide that they will only pay for a percentage of the balance.   

Depending on the type of plan you have, some insurance companies send the check directly to your dentist office. All you pay for at the appointment is any deductibles, copays, or estimated portions.  

For individuals with dental indemnity plans, you pay for the entire procedure at the time of service. You then file the insurance claim on your own, or your dentist does it for you as a courtesy. About a month later, your indemnity carrier sends a reimbursement check to you directly through the mail.   

Preventive by Design  

Most dental insurance plans will cover all or most preventive therapies, like checkups, x-rays, and cleanings. They do this to motivate the enrollee (you) to take advantage of services that reduce the overall expense related to long-term dental care.   

For example, if you see a dentist twice a year and follow their oral hygiene recommendations, you’re less likely to develop gum disease or cavities that someone who isn’t going to the dentist at all.  

Essentially, once you’ve invested in a dental insurance plan, you’ve already paid for your preventive care services. It only makes sense to use those benefits rather than throw them away by avoiding trips to the dentist.   

Reducing the Costs of Dental Care  

“Insurance” by design, is a plan that’s set in place to reduce the expenses related to something that’s unexpected, an accident, or associated with an emergency. What it is not, is a payment program that covers the cost of your dental care in full.   

So, what can you do to lessen the overall bill for your dental treatments, with or without dental insurance?  

  • See your dentist routinely, so that problems can be identified earlier 
  • Treat dental concerns as soon as possible, before they advance into something more complicated 
  • Take advantage of preventive therapies that are covered 100% by your insurance to reduce the risk of oral disease 
  • Monitor your teeth and gums for signs of infection or decay 

“But My Insurance Doesn’t Cover It!”  

Dental insurance plans are designed to cover most people’s oral health needs, but that doesn’t mean they cover all of them. For instance, you may find that investing in a smile makeover is the best step to get ahead in your career (or jump back into the dating scene.) But cosmetic treatments aren’t usually covered by dental insurance. In situations like these, you have to decide if it’s worth paying for the entire thing out of your own pocket. Other examples can include exclusions on certain procedures (like a dental implant or white filling) when something cheaper is available. 

Sometimes treatments that are usually included under your dental insurance plan aren’t covered because not enough time has lapsed. If you need to replace a dental crown that’s six years old, but your plan only covers a new crown every 10 years, you may need to contest the claim or risk having it rejected altogether.   

Alternatives to Employer-Sponsored Dental Insurance  

Buying into your own dental plan can save you money and get the coverage you want, not what’s dictated by your employer. At Cal Dental Plans, we offer a variety of personalized dental insurance and indemnity plans for you to choose from. We also provide dental discount plans, which apply discounts of 10-60% to your dental treatment, if you’re not covered by insurance. Depending on you or your family’s circumstances and budget, you can choose the plan that’s best for your needs. Our savings experts will guide you through the entire process.   

Ready to start saving today? Call Cal Dental Plans to get started. 


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