Dental Insurance – Gahanna, OH

Enjoy Affordable and Effective Oral Care

The American Dental Association recommends vising your dentist for routine checkups and cleanings every six months to address and prevent potentially painful and destructive oral infections, and dental insurance can be a great way to make regular oral care more affordable. Here’s a quick look at how dental insurance works and how the friendly team at Claybrooke Dental of Gahanna can help you get the most out of the benefits you pay for.

How Dental Insurance Works

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Most dental insurance plans offer coverage that works something like this:

  • 100% coverage for routine oral care such as checkups, cleanings, and X-rays.
  • 80% coverage for minor restorative work like fillings and gum disease treatments.
  • 50% coverage for major restorative work like dentures and root canals.
  • No coverage for elective procedures such as most cosmetic treatments.

Orthodontic care may be covered depending on the details of your plan.

PPO plans usually allow policyholders to see any dentist they like, but they typically involve restrictions such as a waiting period before coverage takes effect, a deductible that must be met before the plan starts to pay for anything, or a yearly maximum that defines how much the policy can pay in a year. HMO plans, on the other hand, usually require patients to see in-network dentists to qualify for coverage, but they do not usually impose any restrictions other than that.

What Is the Difference Between Dental & Medical Insurance?

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Medical insurance policies are typically designed to provide for unexpected necessary treatments as well as routine care. Dental plans, on the other hand, are usually designed to encourage policyholders to seek preventive care that can make costly restorative work unnecessary, which helps keep patients healthy and rates low. Using your dental insurance for routine oral care can be a great way to prevent the pain of a severe dental infection as well as the cost of treating it, which can save you much money in the long run.

In-Network vs. Out-of-Network

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HMO policyholders will probably be restricted to seeing in-network dentists to qualify for coverage. PPO policyholders, however, can usually see any dentist they like, but seeing an in-network provider will probably allow them to minimize their costs more than if they see an out-of-network provider.

In-Network Coverage

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A dentist who is in-network with your plan has reached an agreement with your insurance company so they can provide high-quality oral healthcare to policyholders at further reduced rates, which means you’ll probably save more money than if you had seen an out-of-network dentist. The team at Claybrooke Dental of Gahanna is proud to be in-network with:

  • Cigna PPO
  • Guardian
  • Medical Mutual
  • Delta Premier
  • Superior
  • United Healthcare
  • Careington Platinum PPO
  • And many others!

Out-of-Network

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A dentist who is out-of-network with your plan has not negotiated rates with your insurance company. A PPO policyholder will probably still qualify for coverage when seeing an out-of-network provider but not as much as they would if they were seeing an in-network dentist. HMO policyholders, on the other hand, will probably not receive any coverage if they visit an out-of-network dentist.