Your dental insurance, in plain English
Most people have no idea what their plan covers until a bill shows up. Here's how it actually works, and how we make sure you know your number before your visit.
Plans we take
In network with most major plans
- Aetna
- Blue Cross Blue Shield
- Cigna
- Delta Dental
- Dentamax
- Guardian
- Humana
- MetLife
- United Concordia
- United Healthcare
Don't see yours? We likely take it. We also help adult Medicaid patients get the services their plan covers.
No insurance? The Sunshine Membership is $110 a year.
The three buckets
Nearly every dental plan sorts treatment into three groups. Knowing which bucket something falls in tells you most of what you'll pay.
Preventive: usually 100% covered.
Cleanings, exams, x-rays, fluoride. Most plans pay all of this twice a year with no deductible. If you're paying for a cleaning, something is off and we'll help you figure out why.
Basic: usually 70% to 80% covered.
Fillings, simple extractions, deep cleanings, root canals on front teeth. Your deductible usually applies first, then the plan pays its share.
Major: usually 50% covered.
Crowns, bridges, dentures, partials, and sometimes implants. This is where the yearly maximum matters most, because one crown can use up half of it.
Words on your card
- Annual maximum.
- The most your plan will pay in a year, usually $1,000 to $2,000. It resets every January and unused money doesn't roll over. If you have work to do in November, ask us about splitting it across two years.
- Deductible.
- What you pay before the plan starts paying on basic and major work. Usually $50 to $100. Preventive care almost always skips it.
- Waiting period.
- Some plans make you wait 6 to 12 months after signing up before they'll pay for major work. We'll check yours so you're not surprised.
- In network.
- We're in network with most major plans, which means we've agreed to their prices and you pay less. If we're out of network with yours, we'll tell you exactly what that changes.