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Your health insurance covers just about everything except your teeth.  When it's time to head to the dentist, your health insurance likely turns a blind eye to your ailing chompers, but that's not to say that a trip to the dentist isn't going to take a bite out of your wallet.


Much like your car, it doesn't take much to spend a thousand dollars or more. A crown may cost $1,500, and a root canal might run you $300 to $1,000. Even a simple cleaning will likely come in at more than $100.  Dentists aren't cheap and that's why dental insurance coverage may be appropriate for you.


"Do you need dental coverage?"

    By Tim Parker...  


"What questions should I ask?"



Unless you work for an insurance company, you probably do not spend a lot of your time studying all the terminology that dental insurance companies use to describe the treatments and services they cover. It can be a bit confusing.

Here are some of the most commonly used dental insurance terms and what they mean.


  • Annual Maximum–The maximum amount your policy will pay per year for dental care. It is often divided into costs per individual, and (if you are on a family plan) per family.


  • Co-payment– An amount the patient pays at the time of service before receiving care, and before the insurance pays for any portion of the care.


  • Covered Services– A list of all the treatments, services, and procedures the insurance policy will cover under your contract.


  • Deductible– A dollar amount that you must pay out of pocket each year before the insurance company will pay for any treatments or procedures.


  • Diagnostic/Preventive Services– A category of treatments or procedures that most insurance will cover before the deductible which may include services like routine checkups with Bo Davidson, cleanings, X-rays, fluoride treatments, and evaluations.


  • In-Network and Out-of-Network– A list of providers that are part of an insurance company’s “network”.

    • If you visit in-network providers, the insurance company will typically cover a larger portion of the cost of the care you receive. If you visit someone who is not part of the network, known as an out-of-network provider, the insurance company may pay for a portion of the care, but you will pay a significantly larger share from your own pocket.


  • Lifetime Maximum– The maximum amount that a dental insurance plan will pay toward dental care for an individual or family (if you have an applicable family plan).

    • This is not a per-year maximum, but rather a maximum that can be paid over the entire life of the patient.


  • Limitations/Exclusions– A list of all the procedures a dental insurance policy does not cover

    • Coverage may limit the timing or frequency of a specific treatment or procedure (only covering a certain number within a calendar year), or may exclude some treatments entirely. Knowing the limitations and exclusions of a policy is very important.


  • Member/Insured/Covered Person/Beneficiary/Enrollee– Someone who is eligible to receive benefits under a dental insurance plan.



  • Provider– Dentist or other oral health specialist who provides treatment.


  • Waiting Period– A specified amount of time that the patient must be enrolled with an insurance plan before it will pay for certain treatments; waiting periods may be waived if you were previously enrolled in another dental insurance plan with a different carrier.


There are many different insurance options available, so you need to find out exactly what fits your needs.  It’s important to review your plan with a qualified insurance specialist.  


AFI will walk you through the process.  

Call us today !

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