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Understanding Dental Insurance

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understanding dental insurance dentist scottsbluffSo, you’ve got dental insurance—but what does that mean? What can you do with it? What can it do for you? Before calling to make an appointment with a Scottsbluff NE dentist, take a moment to explore your dental insurance plan. Here’s what you should know:

  • When does your benefit year start and end? Some dental insurance plans offer a calendar benefit year—meaning that your benefits start on January 1 and end on Dec 31. However, if your benefits are based on a rolling calendar year, then your benefits are in effect for 12 months from the date of each procedure—no matter when that occurs during the year.
  • What happens to unused benefits? At the end of your calendar year or rolling year, your unused benefits are likely to be forfeited. This means that you must use-or-lose your insurance benefits in any given period.
  • How long is the pre-treatment estimate valid? If you need to have a procedure done and have asked the dentist to send off a pre-treatment estimate to your insurance company, then the estimate may only be valid for a brief period of time. Some insurance plans will honor the estimate for 6 months, and some will honor it for 12 months. To lock in the rate that your insurance company has agreed to, be sure to schedule your treatment within the appropriate time frame.
  • What is the maximum annual benefit? To avoid forfeiting unused benefits, get familiar with your annual maximum. The average dental plan offers a $1000-2500 benefit each year, and you’ll need to keep track of how much you’ve used throughout the year in order to know how much you have left.
  • Is there a replacement or frequency period? If you need to have a procedure repeated, such as a crown, filling, or deep cleaning, it’s important to know how often your insurance plan will pay for it. For example, some plans will only pay for a new dental crown every 5 years or a deep cleaning every 36 months. Some procedures will only be covered once in a lifetime. To avoid an expected dental bill, investigate these restrictions in advance.

For more help in exploring your dental insurance plan, contact a Scottsbluff NE dentist today.

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