How to Pay for Dental Services

How does dental insurance work?

While each dental insurance policy may be different in what the policy covers, it’s important to weigh your options of cost versus reward when selecting your dental plan. Most policies will cover regular dental cleanings twice per year although you may be required to pay a co-pay, such as $25 or $30 each time you visit the dentist. After this, dental insurance policies typically pay for about half of restorative care, such as fillings, tooth extraction or root canals.

However, it’s important to read the fine print on your policy because sometimes policies will only pay up to a certain amount, such as $1,000 to $1,500. This means you must do the math on your insurance policy. If you pay $50 a month, that’s $600 per year. If you do not require extra dental services during this time or the dental services are exponentially higher, you may not be getting enough return on your investment.

How do I file a claim with my insurance company?

Paying with your dental insurance can take some communication between you and your dentist’s office. That’s because some offices will file the dental claim themselves, saving you the time and trouble. If your dentist’s office asks for your insurance card and information such as social security number and your employer’s name (if your insurance is facilitated through your company), these may signal your dentist’s office will file the claim themselves. This means the dental office will bill your insurance company for the costs of your dental visit. Your insurance company will receive the bill and pay according to how your insurance policy explains. You can ask your dentist’s office to send a statement that shows your insurance company has been billed for services.

Of course, there’s always the option that your dentist’s office will ask you to file the claim yourself. In this case, your dentist will send you a bill for services and you will send this along to your insurance company. Check with your Employee Benefits Coordinator or talk to your insurance company about any standardized forms you may be required to fill out to file your claim. You also may wish to visit your insurance company’s website as many claims can now be filed online.

What do I do if my insurance doesn’t pay?

Sometimes insurance companies do not cover dental costs in the amount you thought they would. If this happens to you, and you feel they did not cover the costs according to your policy, you can contact your Employee Benefits Coordinator or insurance company directly to determine if they have an appeals policy. An appeal for a claim typically allows you to state your case, where you can point to specific areas outlined in your insurance policy you believe indicate your insurance company should cover the costs. Be warned that some insurance companies do not always pay in a fast fashion, which means a claim may take 30, 60 or more days to process. Stay in close contact with your insurance company to determine the status of your claim.

Are there ways to get help if I can’t pay for dental services?

Cost can be a barrier for many in getting dental care. A common example is a recent college graduate who is no longer on his parents’ insurance policy and neglects regular dental visits.

“Patients at this age start to let their oral health go, but when they do come in, it’s been 10-plus years since they’ve been to the dentist,” says W. Frank Johnson, DDS, owner of a private practice in Hixson, Tenn. “My advice for the very young adults is to seek care. In the long run, that’s going to save you so much money.” 

If you have neglected visits in the past because you could not afford to pay for dental services, there are often free or low-cost alternatives. Dentists and dental professionals may give away as much as $1.6 billion in dental care a year, according to the American Dental Association. Contact your local health department for information about free clinics or dentists who provide reduced-cost dental services. You also may be able to receive dental care at community- or hospital-sponsored health fairs. Another option is to contact your dentist to determine if she offers need-based discounts or if payment plans are available.