Do you have dental insurance but aren’t sure how to navigate your policy? While each plan can vary from patient to patient, they are all different from medical insurance in that their benefits revolve around preventive care. For this reason, most providers will have a 100-80-50 structure. Not sure exactly what this system means? Read on to learn about your dental insurance plan, factors that can impact your coverage, and how to make the most of your benefits!
What Is the 100-80-50 Structure?
This specific sequence of numbers concerns the amount that will be covered for different kinds of dental services. These will usually include 100% coverage for preventive treatments, 80% for basic procedures like fillings, and 50% for extensive restorations like crowns, bridges, and dentures. Several factors can influence how much of your dental service is covered, which is why you’ll need to verify with your dental insurance company or consult your dental team about the details of your plan in advance.
3 Factors That Affect Dental Insurance Coverage
There are a few essential factors that can affect the 100-80-50 structure of dental insurance, including:
- Annual maximum – Most dental coverage plans include an annual maximum, which refers to the highest dollar amount your insurance company will pay in a particular term.
- Yearly deductible – Certain plans involve an annual deductible, which is the minimum amount of money you will need to pay before you can use your benefits.
- Waiting periods – Depending on your treatment plan, the fine print may include a waiting period for some treatments, such as a 6-12 month wait before you can undergo root canal therapy.
Why You Should See Your Dentist Before the End of the Year
If you don’t know already, most dental insurance plans will rest at the beginning of the calendar year. This means that any benefits you haven’t used will be left behind and won’t roll over after January 1st. That’s why you’ll want to make the most of your coverage by scheduling a visit with your dentist before the year ends! If you’re experiencing a toothache or it’s been longer than six months since your last appointment, now is a good time to enjoy your benefits and save money. This way you’ll be able to avoid having to break the bank to get the dental treatment you need.
Are you finding it difficult to navigate your insurance policy? Feel free to speak with your dental team, and they’ll be more than happy to help you maximize your coverage to preserve a healthy smile!
About the Author
Dr. J. Hamilton Vason earned his dental degree from the Emory Dental School and has delivered outstanding care for well over three decades. He’s also a member of several prominent organizations like the American Dental Association, the Northern District Dental Society, and the Florida Prosthodontics Study Club. He provides a wide selection of high-quality services, including gum disease therapy, crowns, bridges, and root canal therapy. If you need help understanding your dental insurance, don’t hesitate to visit our website or call 404-367-9799.