It is great to have dental insurance. It helps you pay for visits to the dentist. Knowing how your plan works is very important. In fact, understanding your benefits can save you a lot of money. This guide will make it easy to understand your plan. We will show you how to get the most from your coverage right here at Cypress Towne Dental.
This is why we want you to know the rules. You pay for your insurance every month. Therefore, you should use the benefits you have earned. We want you to feel good about your smile. Also, we want you to feel good about the cost of your dental treatment. We are here to help you understand every step.
First, let us talk about your plan details. Most insurance plans have rules. But these rules are simple to learn. You will find all the care you need at our office. Therefore, you can make the best choices for you and your family. Visit us at cypress dental to schedule your next appointment today.
The Simple Rules of Dental Insurance
Dental insurance has three key parts. They are the cost, the limit, and the rules of the money. Because of this, we need to look at each one. Learning these words will make everything clearer.
A. What You Pay: Cost and Deductible
- The Cost You Pay (Premium)
You pay a small cost every month. This is called a premium. This payment keeps your insurance active. So, if you stop paying, your coverage will stop too.
- The Money You Pay First (Deductible)
Next, you have a deductible. This is money you must pay first. It pays for some basic or major services. However, most plans do not make you pay this for cleanings. For example, your deductible might be . You must pay this first. After you pay it, your insurance starts to help pay for bigger things. Because of this, you only pay the deductible once each year.
B. The Yearly Limit (Annual Maximum)
Your insurance has a yearly limit. This is called the annual maximum. This is the most money your insurance will pay in one year. Also, this limit usually renews on January 1st. Because of this, any benefits you do not use are lost. They do not roll over to the next year. Therefore, it is very smart to use all your benefits before the end of the year. We call this a “use it or lose it” system.
C. In-Network vs. Out-of-Network
Some dentists have a contract with your insurance. They are “in-network.” Other dentists do not have this contract. They are “out-of-network.” In fact, we are proud to accept most insurance plans at Cypress Towne Dental. Thus, we can help you check your benefits no matter your plan. However, you might save more money if we are listed as “in-network.” Always ask our friendly team to check your specific plan.
Understanding the 100-80-50 Coverage Rule
Most dental plans follow a simple pattern. This pattern is often called the 100-80-50 rule. This rule shows you what percentage the insurance pays. The higher the number, the less you pay.
A. 100% Coverage: Preventive Care
The Rule: Your insurance pays 100% for preventive services. This means you pay nothing at all. This includes three important things. First, it covers Full Check-ups and Exams. Second, it covers Routine Teeth Cleanings, which are usually two per year. Last, it covers X-rays to look closely at your teeth. Clearly, this is the most important benefit to use. In addition, these free visits stop small problems from becoming big, expensive problems later.
B. 80% Coverage: Basic Procedures
The Rule: Your insurance pays about 80% for basic procedures. This means you pay the remaining 20%. This includes important basic services. These services are Fillings for small cavities, Simple Extractions for pulling a tooth, and Deep Cleanings. Because of this, it is much cheaper to treat a small problem now. Therefore, if your dentist finds a cavity, fix it fast. Do not wait for it to become a major problem.
C. 50% Coverage: Major Procedures
The Rule: Your insurance pays about 50% for major procedures. You pay the other 50%. This includes major procedures like Dental Crowns, Bridges, Dentures, and Dental Implants. Thus, these procedures are more costly for you. However, we help you make a plan. We look at the total cost. We make sure you know what to expect before we start any work.
The Smart Strategy: Maximizing Preventive Benefits
The best way to save money is to use your 100% covered benefits. Using preventive care helps you keep your teeth healthy. It also protects your annual maximum for bigger needs.
A. Use Your Two Cleanings Every Year
Almost every dental plan pays for two cleanings. These cleanings are usually six months apart. Because of this, you should try to schedule them right. If you only go once, you lose the second cleaning benefit. Two cleanings are key for several reasons. First, a hygienist removes plaque and tartar. You cannot remove these things with a toothbrush at home. Also, the dentist checks for small problems. These are problems that you might not even feel yet. Next, early finding of a problem is very important. It means a small filling instead of a large crown. In fact, missing a cleaning is like throwing away money. Make sure you book your two free visits at Cypress Dental.
B. Do Not Skip the Full Check-Up and X-Rays
- The Full Check-Up
Every cleaning includes a full check-up by the dentist. The dentist looks at your gums. They also check all your teeth for soft spots. Therefore, this is a very important part of the visit. It is 100% covered, so use it.
- The Importance of X-Rays
Your teeth have parts you cannot see. X-rays let the dentist look inside your teeth. They can find cavities between teeth. They can also see issues below the gum line. Often, X-rays are covered once a year. But, sometimes, they are covered every few years. So, ask our team how often your plan pays for X-rays. Getting X-rays is vital for stopping problems before they grow.
C. Special Care for Young Smiles
If you have children, use their full benefits too. Pediatric dentistry focuses on building strong, healthy teeth for life.
- Dental Sealants
Kids often get cavities in their back teeth. This is because these teeth have deep grooves. Sealants are a thin, plastic coating. They cover the back teeth. In addition, sealants keep food and germs out. Most plans cover sealants for children.
- Fluoride Treatments
Fluoride is a mineral. It makes tooth enamel very strong. Strong teeth are hard to break. Also, they are resistant to cavities. Fluoride treatments are often covered for children at their cleaning visits. Thus, this simple step protects their smile.
The Calendar Game: Timing Your Visits for Maximum Savings
Since your benefits reset every year, timing is key. You can plan your appointments to save the most money.
A. The End-of-Year Rush (The December Deadline)
Your dental plan calendar year ends. It might end on December 31st. Any money left in your annual maximum disappears. Therefore, December is often a busy time. Here are your action steps. First, check your remaining benefits in October. Next, if you still have benefits left, schedule any needed treatment fast. Because of this, you use the benefits you have already paid for.
B. Using Up Your Deductible Early
If you had a major problem this year, you paid your deductible. Now that it is paid, you should use it. Any extra treatment will be cheaper now. For example, you paid your $50 deductible in March for a filling. If you need a second, bigger procedure in June, you do not pay the deductible again. Your insurance starts helping right away.
C. Splitting Up Major Procedures
Do you need a lot of work? Maybe you need two crowns. The total cost might be more than your annual maximum. However, you can talk to our team about a split plan. Here is how it works. We can do the first crown in October. You use this year’s annual maximum. Then, we do the second crown in January. You use next year’s new annual maximum. Clearly, this smart planning lowers your personal cost over two years.
Our Technology Helps You Save Time and Money
At Cypress Towne Dental, we use the latest tools. This technology makes your visits faster. It also helps us find problems earlier. Early finding means lower costs for you.
A. The Digital Difference
We use digital X-rays. We also use the iTero Intraoral Scanner. This scanner takes a digital picture of your mouth. Instead, you do not need those messy trays. Also, this is faster and much more comfortable for you. In fact, better pictures lead to a better treatment plan. This means less wasted time and cost.
Instant Crowns with Same-Day Service
We use digital technology to make crowns. A crown covers a damaged tooth. Therefore, we can often make and place a crown in just one visit. The benefit is simple. You save time and money. You do not have to come back for a second visit. You also do not need a temporary crown. Thus, this instant restoration is a major benefit for our busy patients.
What If I Do Not Have Insurance?
We believe everyone deserves a healthy smile. But not everyone has dental insurance. If you do not have a plan, we still have ways to help you.
A. In-House Dental Savings Plans
Ask about our special savings plans. These plans are offered right here at Cypress Towne Dental. They are not insured. Instead, they are a simple, yearly membership. You get great things with these plans. First, you get free cleanings and check-ups. Also, you get a discount on almost all other services. Because of this, you can still get the care you need at a lower, predictable price.
Flexible Payment Help
We also work with financing companies. These companies help you pay for bigger procedures over time. You pay in small, easy monthly amounts. Therefore, this makes major care much more affordable right now. In addition, our team will always give you a clear cost breakdown. We do this before any work is started.
Simple Steps to a Healthy Smile
Taking care of your teeth should be easy. First, you need to brush well two times a day. Next, you need to floss every single day. Also, eat foods that are good for your teeth. However, the most important step is to visit the dentist often. In fact, we are here to be your partner in good oral health.