How Does Dental Insurance Work in Coral Gables?

Information may not be reliable

Dental insurance helps pay for treatments like cleanings, fluoride applications, fillings, and oral surgery that improve the overall health of teeth and gums. For most people, going to the dentist isn’t exactly the most exciting activity. With so much uncertainty surrounding cavities and unforeseen costs but going to the dentist is actually a crucial component of maintaining optimal health and enrolling in a dental insurance plan can help with controlling costs, bringing more peace of mind.

• Many patients think their insurance will cover two "free cleanings" a year.  However, many insurance plans will only cover the cost of a healthy-mouth cleaning.  If you're part of the 75% of the American population with periodontal (gum) disease, then you need to ask your insurance plan if it will cover your treatment.
• The insurance company will cover the costs of your visits for periodontal disease management.  Your dentist's office can give you the American Dental Association (ADA) codes to give to the insurance company to make sure you know the exact out-of-pocket costs associated with any procedures.

• Some people sign up for dental insurance because they know they need a crown, implant, denture, or another major procedure done. 
• Some insurance plans require to have coverage for a year before they cover the costs of even an emergency treatment like a root canal.

• The amount of tooth decay is more than what a regular filling can replace but less than what would require a crown to repair, then your dentist may recommend an inlay or onlay. 
•  Both are well-suited for large cavities, but they are more expensive than regular fillings.  Ask your insurance company if it will cover the expense.

• Ask whether the insurance company pays only for non-precious metal or semi-precious metal crowns. These crowns often carry a warranty of one year or less and can cause dark lines around the gums.
•  Dentists may prescribe a higher-quality, more-durable precious metal or all-ceramic crown based on the location of the missing tooth and expected wear. 

• Call your insurance company and go through each step that is outlined. Many insurance companies will not cover the cost of the fluoride treatment, which remineralizes the teeth and helps prevent cavities.

• You may sign up for dental insurance because you have a missing tooth, which if left empty, can cause your other teeth to shift, affect your bite, lead to bone loss and cause your facial muscles to sag, which makes you look older.  

• Your insurance company may cover a procedure performed by a general dentist at one rate, and the same procedure performed by a specialist dentist at a different rate. 
•  It’s important to know what percentage of your cost will be covered should you need to see an oral surgeon, endodontist, periodontist, orthodontist, or pediatric dentist.

• Insurance company about co-pays or deductibles before you visit the dentist.  Your out-of-pocket fees depend on the type of policy your employer has negotiated with the dental insurance company.