Time’s Running Out On Insurance Benefits! By Joni B on November 01, 2020

ANOTHER YEAR IS COMING to a close, and that means another year of insurance benefits is about to expire. If you haven’t taken advantage of your dental insurance yet, that’s okay, but the year is almost over, so the time to use them is now. To help you prepare, we’ve put together some information about how dental insurance works at our practice.

What Dental Plans Typically Cover

Dental Plans vary just as much as vehicles do - it all depends on what you want covered, and what you bought in to.  Many patients have dental coverage through their employer, so it is the employer who chooses what they want to have covered and what is your responsibility.  For the most part, dental plans fall into two categories - those on a percentage basis and those on a fee schedule.

The percentage basis is the most common dental insurance coverage - usually diagnostic and preventive (x-rays, exams, cleanings, fluoride) being covered at 100%, basic (restorations, oral surgery, periodontal and endotontic procedures) typically being covered at 80%, and major (crowns, partials, dentures, implants) usually being covered at 50%.  The fee schedule plans have a set price the insurance will pay for a procedure and the remainder is paid by the patient, with no percentages used.  

On average, most dental plans, regardless of the type of plan it is, will allow exams and cleanings two times a year, and x-rays at least one time a year.  Although usually there is no charge to the patient for these services through their dental plan, the amount of the services rendered does get deducted from your annual maximum amount of benefits allowed.  Also most dental plans have an annual deductible, which is not applied to diagnostic and preventive services.  The moral to this story is:  keeping your cleanings to once every six months will most likely cost you nothing additional out of pocket under dental insurance AND it will keep the possibility of more major issues from arising!

Do You Have Compatible Insurance?

Once again, this varies greatly!  Here at Plymouth General Dentistry, we work with many insurance companies!  Although we may not be contracted with every dental insurance provider, that does not mean you cannot be seen here.  If we are not contracted with your dental insurance provider, you would be responsible for payment at the time services were rendered, and we would provide you with a claim for for submission.  Your dental insurance provider will reimburse you directly!  

Currently, the insurance providers we are contracted with are Delt Dental (all states), Cigna, GEHA, MetLife Dental, Aetna, and Health Plans, Inc.  We also accept dental discount plans offered by those insurance carriers.  

Please do not hesitate to call our office at (603) 536-4301 and ask to speak to someone in the finance office to discuss any questions you may have about your insurance coverage!  We will research your insurance coverage and confirm exactly what you have in remaining benefits, and what procedures you are eligible to receive.  Not only is it a great idea to keep up on your treatment, but to also utilize the insurance benefits you are entitled to.  You make monthly premium payments for your dental coverage - don't let the year end with unused benefits because those benefits don't typically roll over into the following year!

Getting Everything Done On Time

Don't hesitate in calling to schedule your year-end appointment, as these spaces fill up fast.  We will do our best to schedule you before your benefits expire.  Call us at (603) 536-4301.  Feel free to leave a message if after hours and we will return your call.  

If It’s Been A While, Let’s Chat!

If you have more questions regarding your insurance and how to use it, just stop by! We can answer all the questions you have and get you on the right path to affordable dental care!

Take advantage of those benefits while there’s still time!


Top image by Flickr user franchise opportunities used under Creative Commons Attribution-Sharealike 4.0 license. Image cropped and modified from original.


The content on this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of qualified health providers with questions you may have regarding medical conditions.

Joan Kirschner, DDS

Plymouth General Dentistry
Joan Kirschner, DDS

Plymouth General Dentistry is a friendly, patient-focused, privately owned practice. Dr. Joan Kirschner has practiced dentistry since 1983, and she is proud to be affiliated with:

  • The American Dental Association
  • The Academy of General Dentistry
  • The American Academy of Cosmetic Dentistry
  • The New Hampshire Dental Society

You can request an appointment at our office by contacting us online or calling (603) 536-4301.

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