{"id":28,"date":"2025-11-03T20:26:04","date_gmt":"2025-11-03T20:26:04","guid":{"rendered":"https:\/\/www.rockwallcrossingorthodontics.com\/blog\/?p=28"},"modified":"2025-12-15T20:27:48","modified_gmt":"2025-12-15T20:27:48","slug":"dental-insurance-101-four-key-things-to-know","status":"publish","type":"post","link":"https:\/\/www.rockwallcrossingorthodontics.com\/blog\/dental-insurance-101-four-key-things-to-know\/","title":{"rendered":"Dental Insurance 101: 4 Key Things to Know"},"content":{"rendered":"
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\"Dental<\/figure>\n<\/div>\n\n\n

When it comes to taking care of smiles, many patients worry about how much their treatments will cost. It’s easy to imagine being faced with a big bill, but one way you can make these visits more affordable is with dental insurance<\/a>. However, you should understand your plan so you aren\u2019t surprised by anything. To help you learn more about it, here are four things that you may see. <\/p>\n\n\n\n\n\n\n\n

1.)  Deductible<\/h2>\n\n\n\n

Dental plans often have an annual deductible. This is a number that you\u2019ll have to pay yourself before your insurance provider will start to cover a portion of your treatments. Typically, if you pay more per month\/year, then you\u2019ll likely have a lower deductible.<\/p>\n\n\n\n

Although it’s an out-of-pocket cost, preventive care usually doesn’t apply to it. You might be able to get twice-yearly checkups and cleanings without worrying about paying for the entire service yourself.<\/p>\n\n\n\n

2.)  Reimbursement Level<\/h2>\n\n\n\n

Once you reach your deductible, your reimbursement level will kick in. This is how much your provider is willing to pay for specific treatments. Your exact coverage depends on your plan, but many often follow a 100-80-50 payment structure.<\/p>\n\n\n\n

In short, this means they’ll cover 100% of preventive care, 80% of basic services (such as fillings), and 50% of major restorative ones (like crowns). In order to know more about what your plan offers, you can talk to your insurance directly or to your dentist’s front desk team.<\/p>\n\n\n\n

3.)  Yearly Maximum<\/h2>\n\n\n\n

When you start getting coverage for your treatments, then the amount your plan is paying for will start to count towards your yearly maximum. This is the total<\/em> your insurance will cover<\/em> for your dental care. Once you reach it, then you’ll have to start paying out-of-pocket. Generally, it can range from $1,000 to $2,000, but it’s possible for yours to be different.<\/p>\n\n\n\n

Oftentimes, yearly maximums and deductibles reset on January 1st<\/sup> every year you have it. That means you’ll need to reach the latter again, but the former will be zero, so you can get the coverage you’re looking for.<\/p>\n\n\n\n

4.)  Co-Payments & Coinsurance<\/h2>\n\n\n\n

In many cases, an insurance plan has one or the other, but here\u2019s what you need to know about both:<\/p>\n\n\n\n