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Dental Insurance Procedure Categories

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Dental Insurance Categories:

Preventative:  Preventative dental work is typically covered at or near 100%.  Preventative dental work for adults are the following;

  1. Regular Cleanings (Prophy).  You typically receive 2 covered regular cleanings per year
  2. Exams:  Complete Exams, Periodic Exams, and Limited (Emergency) Exams.  You typically received 2 exams per year
  3. X-Rays:  You typically receive full mouth x-rays covered in full every 3 or 5 years.  Then you receive 2 sets of 4-6 X-Rays per year. To learn more about exams and x-rays click here.

Children also receive the following work under Preventative dental work:

  1. Fluoride:  Fluoride is typically covered along with the cleaning.  We recommend that all patients receive fluoride treatments with the cleanings.  However, it is typically only covered for children under the age of 18.
  2. Sealants:  These are covered for children typically under the age of 14.  Sealants “seal” the teeth” to prevent cavities, crowns, and root canals.  If your child is prone to fillings we suggest getting sealants.  They are a great line of defense.

Basic:  Basic dental work is typically covered 80-90%.  This all depends on your dental insurance.  Typically your deductible applies for basic work.  To learn more about deductibles please see our previous blog post.  Dental work that is covered under basic is typically;

  1. Fillings: To learn more about fillings click here.  Note that some time fillings in the back of the mouth are not covered at 80% but often closer to 60%
  2. Deep Cleaning (SRPs): To learn more about SRPs click here
  3. Periodontal Maintenance:  To learn more about periodontal maintenance click here.
  4. Root Canals:  To learn more about root canals click here.
  5. Extractions: To learn more about extractions click here.

Major:  Major dental work is typically covered anywhere from 50-80%.  This all depends on your dental insurance.  Deductibles almost always apply for major work.  To learn more about deductibles please see our previous blog post.  Dental work that is covered under basic is typically;

  1. Crowns: To learn more about crowns click here
  2. Dentures & Partial Dentures: To learn more about dentures & partial dentures click here
  3. Build-Ups:  Build-ups are typically done with a crown when the decay of a tooth has taken away some of the tooth structure.  A build-up is down to create structure on the tooth so that the crown can fit and function properly.
  4. Bridges: To learn more about bridges click here

As alwalys, if you have questions ask us.  Call our office to learn more.  

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