Dental Plan Calendar Year Maximum

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Best Dental Insurance For Implants Of 2023

The cost for a dental implant with insurance depends on how much your plan pays for coverage, your deductible and maximum coverage limits.

Dental Insurance : Learn the Lingo
Dental Insurance : Learn the Lingo

Let’s say you’ve already exceeded your annual deductible and you need a dental implant procedure that isn’t major. It costs $3,000. Say your plan pays at 50% for dental implants and has a $2,000 annual coverage maximum. In that case, the plan would pay up to $1,500 for any dental coverage and you would pay for the remaining $1,500.

Dr. Jaclyn Tomsic, a Cleveland-based oral and maxillofacial surgeon who specializes in implants, warns about additional costs that go beyond the surgical fee to place the implant, including the dentist’s fee for the crown and its replacement.

Dental Insurance Basics: Common Terms Defined
Dental Insurance Basics: Common Terms Defined

Tomsic says it may make sense to spread dental implant work over two calendar years if your plan has annual coverage maximums.

“If only a single implant is needed, it may be beneficial to plan for implant surgery in the last half of the plan’s year and a crown in the first half of the next plan year so that the insurer will cover a portion of both the implant surgery and the crown,” Tomsic says.

What is an annual maximum? I Delta Dental of Kentucky
What is an annual maximum? I Delta Dental of Kentucky

Talk to the dentist and oral surgeon about what work will be involved.

“I always recommend a consultation with your oral surgeon first to discuss what’s involved, after which financial questions can be answered so there are no surprises,” says Tomsic. “I also recommend a consultation with your dentist for a similar discussion about the restorative portion of the implant process, including associated fees.”

Dental Benefits Explained  What is an Annual Maximum
Dental Benefits Explained What is an Annual Maximum

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