Does Insurance Cover All Dental Work?

If you need dental work done in Troy or West Bloomfield and you’re curious about dental insurance, speak with the friendly, knowledgeable team at Perfecting Your Smile – Dr. Pete. Before shopping for a dental insurance policy, there are several things you’ll want to be aware of in order to make the right choice for your budget and needs. 

Dental Insurance – System Overview 

Here’s an overview of how private dental insurance works. First, you review a list of all the dentists that are part of your insurance company’s network. There’s a very good chance you’ll find someone nearby, whether you live in Birmingham or Farmington Hills, and you may even discover that your current dentist is in the network. Different plans are associated with each dentist, so it’s a matter matching the right dentist who is also right for your budget. 

If your current/preferred dentist is in the insurance company’s network, you’ll pay less than you would if that dentist was out-of-network. You can still see this dentist, but the insurance cost will be significantly higher, to the point that you might decide to switch dentists in order to preserve your budget. 

Once you’ve selected a dental plan and a dentist, you’ll pay a monthly insurance premium that keeps you covered. This premium’s amount depends on who your insurance company is, your location, and the specific plan you choose. Just like most other insurance types, your dental insurance premium is billed monthly, whether you use the service or not. So, if your premium is $50/month and you make zero visits to your dentist over a 12-month period, you’ll still pay $600 per year for the coverage.

What Does Dental Insurance Cover/Not Cover?

If you’re wondering, “does insurance cover teeth filling?”, the answer is yes. Fillings, along with numerous other procedures are grouped into three categories of coverage: preventive, basic, and major. Preventive procedures like semi-annual cleanings, x-rays, and sealants, are usually covered 100% by dental insurance. Meanwhile, fillings are part of the “basic” coverage category, along with extractions and gum disease treatment. These treatments often see the dental insurance cover around 80% for these procedures, with the balance (co-pay) paid by the patient. 

The last coverage group – major – is home to treatments that are exactly what the group name implies. These include dentures, bridges, inlays, and crowns. Such procedures have the highest associated co-pays, given their more complex nature. It’s important to understand exactly what procedures your dental policy covers and how they’re classified. For example, some policies may put root canals in the mid-range category while others might include them under the “basic” heading and therefore cover more of the cost. 

Dental Insurance and Cosmetic Procedures

Most dental insurance policies do not cover any cosmetic procedures. This includes teeth whitening, tooth shaping, veneers, and gum contouring. Whereas a filling is considered by the insurance company to be medically necessary, veneers are classified as cosmetic and thus not something that the “average” insured person requires. Patients seeking cosmetic dentistry near Bingham Farms or West Bloomfield will need to cover the procedure 100% out of pocket. 

Get The Low-Down On Dental Insurance Today

From West Bloomfield to Birmingham, Perfecting Your Smile – Dr. Pete has earned a reputation as one of the most trusted dentists in Michigan. Contact us today and we’ll help you answer important insurance-related questions, such as “does insurance cover dental bonding?” and “How is Invisalign classified?”