Insurance is a valuable asset, but one of its downsides is that it can be confusing. Dental insurance is no exception. As you are trying to figure out how to utilize your benefits in the best way, you might run into some unfamiliar lingo, such as “deductible.” What exactly is a dental insurance deductible, and how might this feature of your policy affect your out-of-pocket obligation for various services? This blog post provides practical information on those topics.
What Is a Deductible?
In a nutshell, a deductible is the amount of money that you must pay out of pocket before your dental insurance starts to cover approved services. Often, the deductible is around $50, and it resets at the beginning of every calendar year.
To help you further understand, here is an example of how deductibles work: Imagine that your dentist advises you to undergo a service that has a total price of $300. Your insurance coverage rate is 80%, and your deductible is $50. First, you will pay the $50. Then, your insurance will pay 80% of the remaining balance ($200). You will end up paying $100 out of pocket.
Conversely, if you need a $300 service and you have already paid your deductible for the year, you will only pay 20% of the total cost, which amounts to $60.
There Are Family and Individual Deductibles
If you are the only person covered on your dental insurance plan, you only have an individual deductible. However, if family members are also on your policy, things get a bit more complex. You may have a family deductible in addition to individual deductibles. Often, the family deductible is $150.
Here is an example of how family deductibles work: Imagine that four people are covered on your policy: you, your spouse, and two children. If your family deductible is $150, each person will need to pay a $50 individual deductible, but only until the total reaches $150. Therefore, if you, your spouse, and one of your children pay your deductibles, the other child will not be responsible for any deductible at all.
The Deductible Is Waived for Some Services
Dental insurance usually has a strong focus on prevention, so it often waives the deductible for basic preventive and diagnostic services. You may be able to visit your general dentist for cleanings, exams, and X-rays for nothing out of pocket.
Still Have Questions?
Every dental insurance policy comes with its own unique details; it can be easy to get a little confused! If you need help to figure out how your benefits work, ask your insurance provider or your dental team. They will do all they can to assist you.
Meet the Practice
Northern Virginia Oral, Maxillofacial, and Implant Surgery features a team of specialists who are proud to provide advanced services to our community. We are in-network with several popular insurance plans, and we are always happy to help patients understand how their benefits apply. To learn more about how we may be able to serve you, contact any of our three conveniently located offices via our website or call our Alexandria location at 571-777-6501.