Restorative dentistry involves repairing areas of teeth that have been damaged, due to causes such as an accident or decay. When it comes to how much insurance covers on your treatment though, that restorative work is broken down into different categories, such as preventive, basic(minor) and major. Each category is covered at a different percentage.
Types of Minor Restorative Dentistry Procedures
Basic, or “minor” restorative treatments are a middle-of-the-road category. They come after preventive services like cleanings or exams, but before more complex and major treatments like full mouth reconstruction with crowns and implants.
Here are a few examples of types of basic/minor procedures as they are categorized under a dental insurance plan:
Tooth Extractions — Severe toothaches, emergencies, gum disease, or extensive tooth decay are all common reasons for why a tooth may need to be pulled. Basic extractions that do not require oral surgery (like wisdom teeth) are considered to be minor, straightforward procedures.
White or Amalgam (Metal) Fillings — As you might expect, routine dental fillings are considered a minor procedure. They’re the first phase of restorative treatment that can be used to repair a tooth once a cavity develops. It’s best to go ahead and fill the decay when it’s small so that you don’t need a major crown treatment months down the road.
Root Canals / Endodontics — A root canal is like a filling that extends all the way through the nerve chamber to the tip of the tooth root. It’s used when a tooth has abscessed, to prevent the infection from spreading to other teeth or causing the tooth to need to be pulled.
Periodontal Scaling and Root Planing (“Deep Cleanings”) — These cleanings go beyond what a 100% covered preventive cleaning would include. They’re used when a person has active gum disease and bone loss, to remove bacteria from deep areas under the gums.
Although there are other types of basic dental services used in dentistry, these are some of the most common. Compared to major treatments, minor procedures help restore a specific tooth or the entire mouth back to a disease-free state.
A Word About Maximum Allowables and Deductibles
One area of “fine print” on your dental insurance policy that you want to be sure to check is what your maximum allowable or deductible is. A maximum allowable is a set dollar amount that your insurance will pay for per year, regardless of the type of treatment that you’re having. So even if your plan covers 80% on minor treatments, it won’t pay for any of those procedures if you go over the maximum allowable amount.
What Comes After Basic Dentistry?
When a minor or basic treatment just won’t do, the next level of care are treatments that fall under the major restorative category. These treatments aren’t covered as much by insurance, because they tend to be more expensive (and your carrier wants you to opt for more affordable, preventive services.) As such, the coverage may drop down to as 50% or less, leaving you with the remainder of the bill. Like you may have already realized, it’s best to go ahead and use your insurance on minor treatments so that they don’t have an opportunity to expand into something more severe.
How Much Does Dental Insurance Cover on Minor Treatments?
How much your dental insurance covers for minor or basic dental treatments varies. The type of plan that you’ve purchased may cover, on average, around 75-80% of the overall procedure. The remaining portion of the treatment is paid out of pocket by the patient (you.) This is your insurance company’s gentle way of nudging you toward taking advantage of your preventive care services and treating problems before they become expensive major treatments.
After your dentist has diagnosed specific areas that need to be restored, he or she will have a care plan drawn up that outlines your recommended course of treatment. This plan will include the types of treatments involved, their costs, and how much your insurance is estimated to cover. For basic services, most people will be responsible for an initial deductible, plus the remaining percentage (around 20-25%) that is not covered under the plan. If you’re having a simple filling or two, you may still be left paying for a majority of the procedure.
Opting for a Flat Discount Instead
If you don’t need dental work very often, or you need a whole lot, a dental savings plan may be your best option for minor dental treatment. With a savings plan, the discount is applied to all services, regardless of how many are needed and if they are minor/major. There are no maximum allowables either; you can have as much or as little treatment as you need.
Find the Best Pricing for Your Dental Care
CalDentalPlans.com offers affordable insurance and dental savings plans for families and individuals just like you. Contact us today to find the one that’s right for your smile and budget!