With open enrollment right around the corner and the end of the year approaching fast, you may already be considering a new dental insurance plan for 2027. If you’re shopping for new coverage and aren’t sure how important your deductible will be, here’s a closer look at what this term means, and how it can affect what you owe for your oral health treatment.
What is a Deductible?
Your dental insurance deductible is the annual dollar amount that you must pay your dentist upfront before your dental insurance coverage begins. In most cases, deductibles are based on a 12-month period and will be reset once your new coverage period begins. While in most cases this is each calendar year, it may not always be.
Individual vs. Family Deductibles
There are two different types of deductibles: individual and family. With your individual deductible, you pay your dentist directly, and they submit your claim to your insurance company on your behalf. For example, say your treatment was $200, your deductible is $100, and your plan pays for 80 percent. You would pay your dentist the $100 copay first, and then your dental insurance would pay 80 percent of the remaining $100. You would then be responsible for the remaining $20, which is known as the co-insurance. At this point, because you’ve reached your deductible, your plan would then cover any treatment you receive during the remainder of the year at your agreed upon rate.
Family deductibles are like individual ones but are included in plans that cover multiple people. They generally have a main family deductible in addition to per-person deductibles for each member. So, if your family of four has a $300 dollar deductible and individual deductibles of $100, it would only be met once you’ve reached three out of four of them for the year. After that, your plan’s regular terms would take effect until the year is over.
The Fine Print
In addition to understanding your deductible, it’s important to understand a few dental insurance concepts. First, be aware that different types of treatments may receive different levels of coverage at your insurer’s discretion, and some, like cosmetic treatments, may not be covered at all. In most cases, preventive care like exams and cleanings and X-rays are covered at 100% and won’t count towards your deductible.
Remember, your dental insurance was designed to save you money on you and your family’s oral health care. If you are taking on the important task of choosing a new dental insurance plan this fall, or if you have any questions or concerns about your coverage, don’t hesitate to contact your provider (or future provider), or reach out to your dentist’s office for help. They can help you pick a plan that works for your lifestyle and your budget so you can save money while safeguarding your smile!
About Our Practice
At Dental Designs of Maryland – Columbia we are pleased to welcome many popular dental insurance plans – in fact, we’re even a preferred provider for 90 percent of all PPO plans! To learn more about your dental insurance coverage and see how much you and your family can save when you use it here, contact us for more information. To schedule an appointment, visit our website or call 443-542-9519.