Dental Benefit Basics

Summer school is in session, but this dental benefits overview won’t have tests and stress like a calculus class. Review these three easy lessons to make sure you’re getting the most from your plan.

Dental benefits are designed to focus on prevention. Because preventive care is essential to lifelong oral health, most plans cover the full cost of dental exams and cleanings. Regular appointments allow your dentist to catch oral health conditions early, helping you avoid painful and costly issues down the road. Dental benefits typically cover a wide range of services beyond preventative care, meaning your plan will share the cost of various treatments with you. Check your dental benefits information to see what’s covered and how your dental plan contributes to the cost. To save the most, visit a dentist in your plan’s network. Delta Dental network dentists agree to set fees for certain procedures. These agreements protect you from balance billing, which is when a dentist’s fee for a specific service exceeds the plan’s allowed amount, and the dentist bills you the difference.  Some plans require you to visit a network dentist, so be sure to check your plan information before you schedule an appointment. 

It’s easy to get the care you need with these tools and resources:

Whether you’re on Delta Dental’s website or free mobile app, you can access claims information, view coverage details, find a dentist and more. The app also allows you to quickly schedule dental appointments at your convenience (app available for Apple and Android users).*

Identify your risk for dental diseases with our oral health risk assessment, LifeSmile Score. Knowing your score and sharing it with your dentist can help you both stay on top of your oral health and makethe best decisions for your smile.

Get an idea of how much your next dental treatment will cost with our Dental Care Cost Estimator. You’ll receive estimated cost ranges for common procedures in real time.**

Learn some key terms you might encounter during the course of seeking dental care.

Deductible: A fixed dollar amount you pay out of pocket before your plan begins to cover services. Preventive care is usually exempt from the deductible.

Coinsurance: A fixed percentage of a dental treatment cost that you share with your dental plan. For example, your plan pays for 80 percent of a given service, while you’re responsible for 20 percent of the cost. Your coinsurance begins after you meet your annual deductible.

Copayment: A set dollar amount you pay your dentist for a covered service. You’ll usually have a copayment (also called a copay) or coinsurance but not both.

Annual maximum: The most money your dental plan will pay in a specific 12-month period.

Lifetime maximum: The most money your dental plan will pay over the course of a lifetime. A lifetime maximum may apply to an individual or a family and usually applies to specific types of services, such as orthodontics.

* Appointment scheduling is powered by our partners at BrighterTM. Availability may vary by geographic area and individual dentist participation in Brighter ScheduleTM.

** The Dental Care Cost Estimator provides an estimate and does not guarantee the exact fees for dental procedures, what services your dental benefits plan will cover or your out-of-pocket costs. Estimates should not be construed as financial or medical advice. For more detailed information on your actual dental care costs, please consult your dentist or contact Delta Dental.