What does dental insurance pay for?

The quick answer is not so much anymore. Premiums go up and benefit goes down. According to Dr. Carol Morgan, DDS of Virginia Beach, there have been some big changes in the way dental insurance is handling reimbursement. One change that has caught many patients by surprise is the application of a deductible to their preventive care. For years patients were accustomed to getting a “free cleaning” once every 6 months, but now that’s not always the case. Dr. Morgan’s office has seen deductibles ranging for $50-$100 applied to their check up appointments! This change has left patients paying most of the expense associated with their cleaning in addition to their monthly premium. There are also limitations on what type of dental care insurance will cover. Many insurance companies are still only allowing payment for the unsightly amalgam (metal) fillings despite the many advances in tooth colored filling materials. If a patient elects to have the more aesthetically pleasing tooth colored filling, they are once again left financially responsible for a large portion of the cost. Lastly, there is a maximum yearly benefit many times limited to $1,500 per year, which confuses many patients as they are only familiar with medical insurance, where you do not see such limitation on coverage. Unfortunately, today’s dental insurance is best thought of as an assistance program to help cover the cost of care as opposed to insurance in the traditional sense.