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How Do I Best Use My Dental Insurance?

If you’ve got a dental plan, you probably want to maximize the benefits you get from paying your monthly premium. And Elite Dentistry is here to help. Here’s a quick guide to some of the basic information you should know to make the most of your insurance coverage.

1. Choose An In-Network Dentist In Orlando

Most major dental insurers operate on a PPO (preferred provider organization) model. This means that you can get better coverage and save money if you choose an “in-network” dentist. Contrary to popular belief, you can still file a claim and get compensation for out-of-network dental work, but you will pay more for your care overall.

At Elite Dentistry, we work with most local PPO dental insurance plans, so contact us at (407) 658-0103 to see if we qualify as an in-network provider.

2. Know The Basics Of The 100-80-50 Fee Structure

Most dental plans follow a fee structure called 100-80-50. This means that 100% of the cost of preventive care is covered, meaning you get treatments like teeth cleanings and oral exams for no out-of-pocket cost, usually twice per year.

However, basic treatments like fillings and root canals are covered at 80%, so you will have to pay some money toward your treatment. And “major” treatments such as crowns and dental bridges usually are only covered at 50%, so you’ll pay a higher percentage toward your care.

Of course, your plan may vary, so we highly recommend consulting your insurer for more information about which procedures are covered, and the percentage the company will pay toward each treatment.

3. Consider Your Yearly Deductible And Annual Maximum

Like a health insurance policy, most dental plans have a deductible of between $25 and $250. When you reach this deductible, your policy will start covering the cost of your care.

Your insurance will continue to pay out and cover your dental treatments until you reach your annual maximum benefit, which is usually between $1,000 and $2,000. After you reach this limit, you will be responsible for paying any further dental bills.

There are some cases when you can take advantage of the fact that your annual maximum and deductible reset every calendar year, though. For example, you may be able to get a few fillings in December of one year, then get two crowns in January of the following year. This lets you maximize your insurance payout.

4. Take Advantage Of Our New Patient Special & Payment Plans If You’re Uninsured

Even if you don’t have dental insurance, Elite Dentistry offers a $39 New Patient Special, which includes a teeth cleaning, oral exam, and x-rays. We also offer payment plans through CareCredit, so you can split up the cost of major treatments and get the affordable dental care you need in Orlando.

Contact Elite Dentistry To Get Expert Dental Care In Orlando

Dr. Mark Ashy is here to help you get affordable dental care in Orlando. Whether you have insurance or are currently uninsured, our team can help you keep your mouth healthy. Contact us online or give us a call at (407) 658-0103 to schedule a consultation at Elite Dentistry today.

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