Dental Insurance Deductibles: Everything You Need to Know

June 8, 2023

Filed under: Uncategorized — southlakedental @ 5:01 pm
The word “Deductible” underlined with marker

Dental insurance can be confusing at times, which is why it’s important for patients to familiarize themselves with their plans as well as some key terms. One word that you definitely need to know is “deductible,” as it could have a significant effect on your out-of-pocket costs for dental treatment. Take the opportunity to learn more about what a deductible is and how it works.

What is a Deductible?

With dental insurance, the deductible is a set amount of money that you’re required to pay before receiving coverage for dental treatments. Each plan is different, so the amount isn’t set in stone, but it can be anywhere from $50 to $100.

One important detail about dental insurance deductibles is that they’re annual. That means that once you have reached your deductible, you don’t have to pay it again for the rest of the year. However, once your plan resets, you’ll have a new deductible to meet.

How Exactly Do Deductibles Work?

You’ll be responsible for paying your deductible when you have a dental treatment performed. It will be part of the overall cost of the service. This makes your deductible different from your premiums, which are separate fees that are paid monthly regardless of whether you had dental work performed recently.

Sometimes your dental insurance company might waive your deductible for routine checkups and cleanings. As such, if you don’t have any dental work done during the year aside from your regular preventive dental appointments, you may not have to pay your deductible at all. You can speak to your insurance company to confirm what services are and are not subject to a deductible.

What About Family Deductibles and Individual Deductibles?

When you have a family dental insurance plan, you’ll need to consider family deductibles as well as individual deductibles. Each person included in the plan will have an individual deductible that goes toward the family deductible.  

To help clarify what this means, here’s an example. Let’s say that a family of five has an insurance plan with a family deductible of $100 while each person has an individual deductible of $50. If just two people meet their individual deductibles, it will fulfill the overall family deductible. As a result, the remaining family members won’t have to worry about reaching their individual deductibles before receiving treatment.

Hopefully, the above information gives you a clearer picture of what a deductible is. Remember that you can always speak to the helpful team members at your dental practice if you have any questions about your insurance coverage.

About the Author

Dr. Priya Chougule earned her Doctor of Dental Medicine at the University of Connecticut. She loves helping families smile at her Fort Mill practice, Southlake Family Dentistry. She is proud to be in-network with Delta Dental Premier and Cigna, and she accepts claims from other insurance providers as well. If you would like to get in touch with Dr. Chougule, visit her website or call (803) 548-3342.

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