Maintaining good oral health is crucial, but navigating dental insurance plans can be confusing. A common question patients ask is “what is considered major dental care?“. Knowing the difference between basic and major dental services can help you understand what your insurance covers and plan for potential costs.
This blog post from New Hyde Park Dental clarifies the distinction between major and basic dental care and explores some of the most common major dental services. We’ll also provide tips on maximizing your dental insurance benefits.
Understanding Dental Insurance Coverage
Most dental insurance plans fall into one of three categories:
- Preventive: This category covers routine checkups, cleanings, and X-rays. These services are typically covered at 100% after meeting your annual deductible.
- Basic: This category covers basic procedures like fillings, extractions, and simple root canals. These services might require a copay or coinsurance payment from you.
- Major: This category covers more complex and expensive procedures considered major dental care. Coverage for major services often comes with higher deductibles and coinsurance percentages.
What is Considered Major Dental Care? Common Major Services Explained
Here are some of the most common procedures categorized as major dental care:
- Dental Implants: These are artificial tooth roots surgically implanted into the jawbone to replace missing teeth. Implants offer a permanent and stable solution for missing teeth, but they are also one of the most expensive dental procedures.
- Crowns and Bridges: A crown is a cap placed over a damaged or weakened tooth to restore its structure and function. Bridges are used to replace missing teeth by anchoring a replacement tooth (pontic) to healthy adjacent teeth with crowns.
- Full Dentures and Partial Dentures: Dentures are removable replacements for missing teeth. Full dentures replace all teeth in an arch, while partial dentures replace only a few missing teeth.
- Oral Surgery: Some dental procedures require oral surgery, such as wisdom tooth extraction, complex root canal surgery, or jaw surgery. These procedures are generally considered major dental care.
- Periodontal Treatment (Advanced Gum Disease Treatment): This category includes procedures like scaling and root planing (deep cleaning) for advanced gum disease. While routine cleanings are preventive care, advanced gum disease treatment often falls under major services.
Factors Affecting Coverage for Major Services
The specific coverage for major dental services can vary depending on your individual dental insurance plan. Here are some factors to consider:
- Annual Maximums: Many plans have annual maximums, which limit the total amount the insurance company will pay for covered services within a year.
- Deductibles: You may have a deductible, which is the amount you must pay out of pocket before your insurance coverage kicks in for major services.
- Coinsurance: After meeting your deductible, you might be responsible for a coinsurance percentage for major services. For example, a 50% coinsurance would mean you pay 50% of the cost after your deductible, and your insurance pays the remaining 50%.
Maximizing Your Dental Insurance Benefits for Major Services
Here are some tips for maximizing your dental insurance benefits for major dental care:
- Understand Your Plan: Take time to read and understand your dental insurance plan details. This includes knowing your coverage categories, annual maximums, deductibles, and coinsurance percentages.
- Schedule Regular Checkups and Cleanings: Regular preventive care can help identify and address potential problems early on, potentially preventing them from becoming major dental issues.
- Communicate with Your Dentist: Discuss your treatment plan with your dentist and understand any potential costs associated with major services. Your dentist can help you determine if your insurance covers specific procedures and can provide estimates for your out-of-pocket costs.
- Consider Payment Plans: Some dental practices offer payment plans for major services to help patients manage the costs.
Schedule an Appointment at New Hyde Park Dental Today!
At New Hyde Park Dental, we strive to provide comprehensive dental care in a comfortable environment. Our team can help you understand your dental insurance coverage and discuss treatment options for major dental services. We are committed to providing quality dental care that fits your budget.
Contact us today to schedule an appointment!
