Shouldn't My Dental Insurance Pay for That?
Understanding your Dental Insurance and the questions to ask when shopping for coverage.
What is my yearly maximum?
The dental insurance yearly maximum limits are what the insurance carrier has to cover each year for their members.
This differs from traditional medical insurance, where there is typically no maximum, and members will pay out of pocket for services till they reach their deductible and out of pocket max, after which the insurance company will pay for all services at 100%.
Dental "Insurance" works more like a discount plan. The insurance company will allow you a certain amount of yearly benefit, typically averaging around $1500. However, it comes with certain conditions (explained further below).
Why doesn't my yearly maximum cover my dental work?
Amazingly, even though expenses and cost of living, have steadily increased over the last 70 years, annual maximum levels for dental care have not changed since the 1950’s. What we are observing is that insurance companies are not providing the benefits their members need to cover the rising costs of quality dental care that they deserve.
Lets say you are getting a filling done. The insurance company, rather than deducting the total cost of the filling from the yearly maximum, they will instead cover