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Dental Insurance FAQ: The Basics

North Reading dentist, Dr. Judy Marcovici at Inertia Dental, discusses dental insurance and answers patients’ frequently asked questions.At Inertia Dental, we understand that dental insurance can be tricky to navigate. Evaluating dental plans and considering deductibles, benefits, which treatments are covered, and the mountain of other information insurance companies provide can be a headache in and of itself. 

Dr. Judy Marcovici wants every North Reading patient to have the power to control their health, so here’s a simplified guide to the basics of dental health insurance

Dental Insurance

Dental insurance is an excellent investment that helps people ensure a lifetime of healthy smiles. However, to get the best value from your dental insurance, there are a few things you need to know. Here are the answers to the most common questions we hear at Inertia Dental.

What is Dental Insurance?

Having dental insurance means that an insurance provider will pay for a percentage of the dental care that you need every year. Plans vary in terms of how much they cost, how much they cover, and which dentists are included. If you would like to know if Dr. Judy Marcovici is included in your provider network. Please contact Inertia Dental today.

What Do Dental Insurance Plans Cover?

Insurance carriers cover dental procedures in three fundamental categories:  preventive (examinations, routine cleanings, x-rays, etc.); basic/restorative (cavity fillings, tooth extractions, etc.); and major (crowns, bridges, surgical extractions, dental implants, etc.). 

The classification of procedures into categories varies according to each insurance provider, but most dental insurance plans have “100-80-50” coverage, which means routine cleanings, checkups, and diagnostic care are paid for in full; 80 percent of the cost of fillings, root canals, and other basic procedures are covered; and 50 percent of the cost of dental implants and other major procedures are covered. Cosmetic dental procedures, such as whitening treatments, are not usually covered.

Premiums, Copays, Deductibles & Maximums

  1. Premiums – These are the basic yearly or monthly cost of your dental insurance. Premiums do not include copayments or deductibles.
  2. Copayments – Per-visit payments of a flat rate or a percentage of the total appointment cost.
  3. Deductibles – For each plan, there is an annual amount that you must pay before insurance will cover expenses. After your deductible is met, your insurance plan will cover a percentage of the cost of your dental care.
  4. Plan Maximums – Most plans include a maximum dollar amount that will be paid for your dental expenses. You are financially responsible for any amount exceeding your plan maximum.

When Do Benefits Renew? 

Benefits are usually calculated yearly and renewed on the 1st of January. It is important to know that unused coverage does not carry over to the next year.

If you have specific questions about your dental insurance, you can contact your insurance provider directly or contact Inertia Dental today! We are always happy to answer any questions that help keep North Reading smiles beautiful and healthy.

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.

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We will use your information to respond to you, regarding the reason you contacted us. Unless you ask us not to, we may contact you via email in the future to tell you about specials, new products or services, or changes to this privacy policy.

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While we use encryption to protect sensitive information transmitted online, we also protect your information offline. Only employees who need the information to perform a specific job (for example, billing or customer service) are granted access to personally identifiable information. The computers/servers in which we store personally identifiable information are kept in a secure environment.

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  3. The security procedures in place to protect the misuse of your information.
  4. How you can correct any inaccuracies in the information.

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When Personal Health Information (PHI) is requested, we abide by all Health Insurance Portability and Accountability Act of 1996 (HIPAA) rules and regulations to protect your information and privacy. We are required by applicable federal and state law to maintain the privacy of your health information. We are also required to give you this Notice about our privacy practices, our legal duties, and our rights concerning your health information. We must follow the privacy practices that are described in this Notice while it is in effect. This notice takes effect January 1, 2019, and will remain in effect until we replace it. We reserve the right to change our privacy practices and the terms of this Notice at any time, provided such changes are permitted by applicable law. We reserve the right to make the changes in our privacy practices and the new terms of our Notice effective for all health information that we maintain, including health information we created or received before we made the changes. Before we make a significant change in our privacy practices, we will change this Notice and make the new Notice available upon request. You may request a copy of our Notice at any time. For more information about our privacy practices, or for additional copies of this Notice, please contact us using the information listed at the end of this Notice.

Wherever we request sensitive information (such as personal health information (PHI)), that information is encrypted and transmitted to us in a secure way. You can verify this by looking for a lock icon in the address bar and looking for “https” at the beginning of the address of the Web page.

We are the sole owners of the information collected on this site. We only have access to/collect information that you voluntarily give us via email or other direct contact from you. We will not sell or rent this information to anyone.

We will use your information to respond to you, regarding the reason you contacted us. We will not share your information with any third party outside of our organization, other than to perform quality of service analysis and as necessary to fulfill your request, e.g. to respond to your queries. We may use your information to review our interactions with you and to help us improve and provide you with the best experience possible.

Unless you ask us not to, we may contact you via email in the future to tell you about specials, new products or services, or changes to this privacy policy.

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You may opt out of any future contacts from us at any time. You can do the following at any time by contacting us via the email address or phone number given on our website:

  • See what data we have about you, if any.
  • Change/correct any data we have about you.
  • Have us delete any data we have about you.
  • Express any concern you have about our use of your data.
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  • You have additional rights, please contact the office for the latest copy of our Notice of Privacy Practices and to ask any questions.

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We take precautions to protect your information. When you submit sensitive information via the website, your information is protected both online and offline.

Wherever we collect sensitive information (such as personal health information or credit card data), that information is encrypted and transmitted to us in a secure way. You can verify this by looking for a lock icon in the address bar and looking for “https” at the beginning of the address of the Web page.

While we use encryption to protect sensitive information transmitted online, we also protect your information offline. Only employees who need the information to perform a specific job (for example: billing or customer service) are granted access to personally identifiable information. The computers/servers in which we store personally identifiable information are kept in a secure environment.

If you feel that we are not complying with your rights, you should contact us immediately via telephone or email. You also have the right to contact Health and Human Services (HHS) (https://www.hhs.gov/hipaa/filing-a-complaint/). We will not retaliate against you for filing a complaint.

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