Dental plans use their own vocabulary, and the details vary a lot from plan to plan. This short guide explains the terms you’re most likely to see, so the questions you ask — of your insurer and of us — get clearer answers.
The words on your plan
- Premium — what you pay for the plan itself, usually monthly, whether or not you visit the dentist.
- Deductible — the amount you pay each plan year before the plan starts sharing costs for certain services.
- Coinsurance or copay — your share of a covered service, either as a percentage or a fixed amount.
- Annual maximum — the most the plan will pay in a plan year. Costs above it are yours.
- Waiting period — time after joining a plan before some services are covered.
- In-network and out-of-network — whether a dentist has an agreement with your plan. It can change what you pay.
Preventive, basic and major
Many plans group services into categories — often preventive care such as exams and cleanings, basic care such as fillings, and major care such as crowns — and cover each category differently. Your plan documents, or your insurer’s member line, will tell you how yours works.
Questions worth asking
- How much of my deductible and annual maximum is left this year?
- Is there a waiting period for the service I need?
- How often does my plan cover exams and cleanings?
How it works with us
Plans vary too much to list here, so we check yours individually. Call us and tell us your insurer and plan, or mention it when our team contacts you to confirm your visit — and please bring your insurance card. If treatment is recommended, you’ll get an estimate before anything is done.
