It might be hard to believe, but 2025 is already well underway. You may have a whole new year of dental insurance benefits ready to use. Have you started meeting your deductibles yet? Admittedly, that aspect of your benefits can be confusing. What should you know about it? This blog post aims to provide some helpful information.
What Is a Deductible?
A deductible is the amount of money that you are required to pay out-of-pocket before your insurance benefits kick in to cover certain services. Here is an example: Your insurance may cover 80% of the cost of basic services, such as fillings. However, if you have not yet met your annual deductible, you will have to pay its full amount. Then, your insurance will pay 80% of the remaining balance.
Here are a few important points to keep in mind about deductibles:
- They are common among PPO plans, but less so with DHMO plans.
- Deductibles are typically paid just once a year.
- For dental insurance, deductibles are often $50 – $100.
- In most cases, deductibles apply regardless of whether you see an in-network or out-of-network dentist. Overall, though, fees are usually lower at in-network practices.
Individual and Family Deductibles
What if your dental insurance plan covers more than one person? You may have both individual deductibles and a family deductible.
To understand how that works, imagine your individual deductible is $50, and your family deductible is $150. You, your partner, and one of your kids each have to meet the $50 deductible. Because those three payments equal the family deductible, any remaining people on your plan may not have to pay any deductible at all.
Are Any Services Exempt from Deductibles?
Some insurance companies waive deductibles for preventive services. Therefore, there is a chance that you could enjoy cleanings, exams, and routine X-rays for nothing out of pocket. Check with your insurer to see if that is true in your case.
Dental insurance terminology can be confusing sometimes. To learn more about how to use your benefits, ask your dental care team for assistance.
Meet the Practice
At the Center for Contemporary Dentistry, we strive to provide top-quality care in a welcoming environment. We accept dental insurance, and we are in-network with many popular plans, including those from MetLife, Guardian, Aetna, and more. To learn how you can maximize your benefits in our practice, get in touch with our friendly team at 603-556-7047.