Dental Insurance – Gorham, ME
We’re Happy to Help You Maximize Your Benefits
Dental insurance plans are notoriously difficult to navigate, but thanks to our front desk staff’s extensive experience when it comes to filing claims and maximizing benefits, we’re able to help you save at each visit. While our practice isn’t contracted as an in-network provider with any plans, oftentimes, patients pay near the same to see our wonderful team as they would an in-network dentist. If you have any questions about your insurance coverage, never hesitate to reach out to us!
How Dental Insurance Works
In order to understand how dental insurance works, it’s important to know some of the most common terms your dental insurance company and our office will reference when speaking to you about your coverage:
- Deductible – The out-of-pocket cost your insurance will expect you to pay before your dental insurance benefits kick-in.
- Maximum – The annual maximum amount your dental insurance company will pay out for treatments over the course of the year.
- Expired Benefits – While this isn’t a term that you’ll likely hear your insurance talk about, any amount of your annual maximum that hasn’t been used by January 1st will disappear. This is because January 1st is when most plans renew.
The Difference Between Dental & Medical Insurance
Unlike medical insurance, whose coverage predominantly focuses on treating issues as they arise, dental insurance plans are geared towards covering the cost of preventive care. Most dental insurance plans use a 100-80-50 coverage structure. This means that they typically cover 100 percent of the cost of preventive routine care (like checkups and cleanings), 80 percent of basic services (like cavity fillings), and 50 percent of more extensive procedures (like root canal treatment and tooth extractions).
Seeing an In-Network vs. Out-of-Network Dentist
If you have a PPO dental insurance plan, which stands for “Preferred Provider Organization,” then you have the option to choose between an in-network and out-of-network dentist. In-network dentists have been contracted by your dental insurance company to offer discounted fees to their customers, while out-of-network dentists aren’t contracted by your dental insurance company.
While many people think that out-of-network dentists are much pricier than in-network offices, that’s actually not the case. For most of our patients, we’re able to keep their out-of-pocket expenses almost as low as if they were seeing an in-network provider, allowing them to choose a team they trust to take care of their family’s smiles!