Patients frequently ask many questions about their dental insurance.  It can be confusing and sometimes overwhelming trying to understand your plan benefits  so, let’s try to unravel the mysteries of the insurance world together.

• What does” insurance maximum” mean? The maximum is a dollar amount (for example $1000.00) determined by your employer that can be applied to your covered dental procedures. This amount is available to use during your contract year.
• Is the maximum for my whole family? No. Each eligible family member receives their own  yearly maximum.
• When is the contract year? This is decided by your employer, and can run from January 1st through Dec 31 st-commonly referred to as a calendar year, or any month for example June 1st through May 31st is referred to as a fiscal year.
• Can we use other family member’s maximums? No, unfortunately there is no sharing of maximums.
• If I do not use all my insurance money will it carry over to next year? No. Whatever insurance money is not used during your contract year is lost.
• If I have a $1500.00 maximum, can I use this whole amount for one service? No. Insurance plans are set up with 3 different categories or levels of coverage. One is preventative–two is basic –and three is major. Each one of these categories is paid at a specific percentage of coverage. For example:  a healthy mouth cleaning may be covered at 100%, whereas  a root canal may be covered at 70%, and a crown might be at 50%.
• Aren’t preventive services covered no matter what? No. Even if your contract states coverage at 100%, you must have money available in your current maximum to cover the visit. All services are subtracted from your maximum.

Join us tomorrow for more information regarding your insurance policy. Please feel free to submit any questions you may have.