How Can I Take Full Advantage Of My Dental Insurance Coverage?

How Can I Take Full Advantage Of My Dental Insurance Coverage?

If you pay for a dental plan, it’s only natural that you’d want to get the most from your monthly premium payments. So in this guide from Midtown Dental Clinic, we’ll discuss a few strategies you can use to get more from your insurance plan. Let’s get started now. 

1. Get Care From An In-Network Dentist When Possible

Like a lot of health insurance plans, most dental plans are PPOs. In this model, you will pay less for dental care when you choose an “in-network” provider, compared to out-of-network dentists, so it’s a good idea to see an in-network dentist in Southeast Washington. 

At Midtown Dental Clinic, we accept major insurances common in the area including Metlife, Delta Dental, BlueCross BlueShield, Cigna, and Sun Life Financial. Contact us for more information and to ensure we accept your policy. 

2. See Your Dentist At Midtown Dental Clinic Twice Per Year

Almost all dental plans cover the full cost of two preventive exams and teeth cleanings per year, along with a set of annual x-rays. Kids under 18 may also get coverage for fluoride treatments and dental sealants.

Make the most of your coverage by seeing your dentist at Midtown Dental Clinic twice per year. This keeps your mouth healthy and ensures you enjoy all the benefits that your dental plan provides. 

3. Understand The 100-80-50 Dental Coverage Model

The 100-80-50 model is the most common type of dental coverage offered by insurers. In this model:

  • Your plan pays 100% of the cost of preventive care like teeth cleanings and oral exams
  • Your plan pays 80% of the cost of basic care like fillings and root canals
  • Your plan pays 50% of the cost of major care like crowns and bridges

So while preventive care is covered, all other treatments will require some kind of out-of-pocket payment. And the more serious your condition is, the less your insurer will pay toward your care.

4. Be Aware Of Your Annual Maximum & Yearly Deductible

Most dental plans have a deductible, similar to healthcare plans. This is usually set at $25 to $250, but may vary. Your plan will only start paying toward your care once you hit this threshold.

Unlike healthcare plans, though, dental plans have an annual maximum, too. As the name may suggest, this is the maximum payout your play will provide for dental care in a calendar year. It’s usually between $1,000 and $2,000.

5. Understand Your Options For Financing Your Treatment

The structure of most dental plans means that you’ll face some out-of-pocket costs if you need any significant dental work at Midtown Dental Clinic. If you’re worried that you can’t pay the full amount at once, don’t worry! 

We offer financial options like CareCredit, one of the largest, most reputable healthcare financing providers in the US. Whether you have insurance or you’re uninsured, financing your treatment with CareCredit lets you split it into affordable monthly payments.

We also offer a $99 new patient special for uninsured patients, which includes a teeth cleaning and oral exam, as well as a set of x-rays. 

Contact Midtown Dental Clinic To Get The Dental Care In Southeast Washington 

At Midtown Dental Clinic, we serve our patients with expert dental treatment, and we can help you make the most of your insurance policy and explore your options for financing your care. Contact our Richland or Kennewick office now to get the care you need right away.


750 George Washington Way,
Richland, WA, Suite 1 99352

Office Hours

MON8:00 am - 5:00 pm

TUE8:00 am - 7:00 pm

WED - THU8:00 am - 5:00 pm

FRI7:00 am - 2:00 pm

SAT - SUNClosed