With inflation getting so far out of hand, you worry about where every dollar goes these days. So when you get a bad toothache and need to see your emergency dentist, you naturally become concerned about how much you’ll have to pay. You tell yourself that you have dental insurance, but how much will it actually cover? Unfortunately, coverage for dental emergencies can be different, depending on which company and plan you have. Keep reading for more information that can give you a clearer idea of what you can expect of your insurance in terms of coverage and cost!
Types of Dental Insurance Plans
The first thing you need to know about your insurance is which type of plan you have. Generally, there are three types:
- Preferred provider organization (PPO): This is the most common type of dental insurance. For the most savings, you need to visit a dentist that is in-network (i.e., a dentist who has agreed to lower rates for certain services). Visiting an out-of-network dentist will cost more.
- Dental health maintenance organization (DHMO): With DHMO, there is a list of approved dentists you may visit. Going elsewhere could result in no coverage.
- Discount dental plan: This plan can only be used at a small selection of practices. No services are covered in full, but you can get discounts on whichever services you receive.
What Dental Insurance Covers
With a PPO plan, when you go in for your routine dental checkups and cleanings, you may pay very little or nothing at all out-of-pocket; however, if you need to see the dentist for an emergency visit, don’t expect the same amount of coverage. While diagnostic X-rays may be covered, most insurance plans will contribute about 70 to 80 percent of the total cost for minor problems that require fillings or other small repairs. Major repairs with crowns, bridges, or dentures are about 50 percent covered, which means you’ll pay about half of the total cost yourself.
Please note that these are general coverage estimates and that your insurance could differ in the specific amount it will pay toward your emergency care.
How to Make the Most of Your Insurance Benefits
You may have noticed in the previous section that insurance tends to pay more for preventive care and less invasive treatment. To get the most bang for your insurance buck, you should be proactive and take excellent care of your teeth and gums at home, stay up-to-date on your six-month dental appointments, and seek help as early as possible if you notice a problem.
It’s never a good idea to postpone emergency care. Although you may think putting off treatment for a dental problem could “save” money, the truth is that the longer you wait to resolve the issue, the more expensive it is likely to be. Cavities, damage, and other problems only get worse over time, requiring more extensive treatment and costing you more out-of-pocket.
In the end, the only way to know how much you will pay out-of-pocket to deal with your dental emergency is to actually go into the dental office and be examined. Regardless of your insurance situation, the earlier you get help, the sooner you can get back to perfect oral health and the less it will cost.
About the Practice
At Stone Street Dental, formerly known as Duncan Dental, Dr. Alison Garrad and Dr. Gregory Duncan are proud to be in-network with many PPO dental insurance plans, including Cigna, Delta Dental, and Blue Cross Blue Shield. Our practice also offers a membership plan for those who do not have insurance, helping everyone get affordable dental care. If you have a dental emergency or a question about insurance, you may contact us online or call our Greenville office at 903-455-6075.
