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Myth: Dental insurance covers every type of dental procedure. Reality: Most dental insurance plans primarily cover preventive care, such as cleanings and exams, and may only partially cover restorative treatments like fillings, crowns, and root canals. Cosmetic procedures (e.g., teeth whitening or veneers) are often not covered or are covered at a reduced rate.
Myth: If you don’t use your dental insurance, your benefits roll over into the next year. Reality: Most dental insurance plans have a “use it or lose it” policy. If you don’t use your benefits within the calendar year, they typically expire, and any unused benefits will not carry over.
Myth: I have to meet my deductible before any dental care is covered. Reality: Preventive care, such as cleanings and exams, is usually covered at 100% by most insurance plans even before your deductible is met. However, for more extensive treatments, like fillings or crowns, you may need to meet your deductible before insurance covers a portion.
Myth: Once I meet my deductible, all dental procedures are covered 100%. Reality: After meeting your deductible, insurance often covers a percentage of the cost (e.g., 50% to 80%), depending on the procedure. You are typically responsible for paying the remaining portion (co-pay or coinsurance).
Myth: I can only see dentists who are in my insurance network. Reality: While it’s often more affordable to visit an in-network dentist, most insurance plans allow you to see out-of-network dentists at a higher out-of-pocket cost.
Myth: There are always long waiting periods for major procedures. Reality: Some insurance plans have waiting periods (typically 6 to 12 months) for major services like crowns or dentures, we offer Care Credit to help patients receive care without delay.
Myth: All dental insurance plans cover orthodontic treatments like braces or Invisalign. Reality: Coverage for orthodontic treatment varies significantly by plan. Some plans may cover a portion of the cost, while others exclude orthodontics entirely. It's best to check with your provider to see what is covered.
Myth: Dental insurance doesn’t cover emergencies. Reality: Many dental insurance plans cover emergency care for situations like severe tooth pain, trauma, or infection. However, the extent of coverage depends on the treatment needed (e.g., extractions or root canals), and co-pays may apply.
Myth: It’s better to save dental insurance benefits for major treatments and skip routine care. Reality: Skipping preventive care can lead to more extensive and expensive problems down the road. Most insurance plans cover preventive services like cleanings and exams at little to no cost, which can help avoid the need for major treatments later. For any major treatments, it is best to check with your provider before scheduling an appointment.
Myth: Dental insurance always covers dental implants. Reality: While some insurance plans provide partial coverage for dental implants, many treat them as a cosmetic procedure, which may not be covered. However, some plans may cover portions of the process, such as extractions or crowns, so it’s important to verify with your provider.
Myth: If my dentist isn’t in-network, I’m stuck with my current insurance. Reality: You can change your dental insurance plan during the open enrollment period or if you experience a qualifying life event.
Myth: All dental insurance plans cover treatment for TMJ (Temporomandibular Joint Disorders). Reality: TMJ treatment coverage varies by plan. Some dental insurance policies do not cover TMJ treatments at all, while others may cover only certain aspects, such as oral appliances or physical therapy. Always check with your insurance provider for specifics.
Myth: Cleanings and exams are only needed once per year and are fully covered. Reality: Most dental plans recommend two cleanings per year, and these are often fully covered under preventive care. Regular exams and cleanings help prevent more costly issues down the road, so it’s important to follow your dentist’s recommendations.