May 16, 2023

What Can I Do To Get The Most From My Dental Insurance Policy?


If you’re sending a dental insurance company money every month for your premiums, you probably want to make sure you get the most out of your coverage. That’s only natural! And in this blog from Waterfront Dental, we’ll discuss a few of the steps you can take to do just that. Read on and learn with us.

1. Find An In-Network Dentist In Baltimore 

Most dental plans are PPOs. That means that you technically can get out of network care. However, your plan will cover it at a lower rate compared to an in-network dentist. For that reason, you should find an in-network family dentist in Baltimore for your routine dental care.

At Waterfront Dental, we’re in-network with a wide variety of insurance companies. To see if we work with your insurer, just give us a call at (410) 505-0551. 

2. Visit Dr. Dawn Merguerian Twice Per Year For Preventive Care

Most dental plans cover preventive care at no out-of-pocket cost, including two oral exams and teeth cleanings per year, along with one set of x-rays. So make sure you see the dentist every six months to maximize your benefits. 

3. Understand The 100-80-50 Coverage Model & Maintain Good At-Home Oral Hygiene

Dental plans usually require you to pay some out-of-pocket fees, and use a 100-80-50 coverage model.

  • 100% of preventive care like teeth cleanings and oral exams will be covered
  • 80% of basic care like fillings and root canals will be covered
  • 50% of major care like dental crowns/bridges or dentures will be covered

Because of this, it’s very important to maintain good at-home oral hygiene. By avoiding the need for basic care and major care, you can reduce your out-of-pocket costs.

4. Know Your Yearly Deductible And Annual Maximum Benefit 

In addition to coinsurance, your plan will have a deductible, usually between $25 and $250. This is how much you need to spend before the plan begins paying toward your dental care.

Most dental plans also have an annual maximum benefit of between $1,000 and $2,000, meaning they stop paying out if you exceed this limit. 

Your annual maximum and yearly deductible typically roll over on January 1st, so we can sometimes work to spread out your care and minimize your out-of-pocket costs.

5. Consider An In-House Plan If You’re Not Insured

Not everyone has dental insurance, but that doesn’t mean you’ll be stuck paying high out-of-pocket costs at Waterfront Dental. We offer a $149 New Patient Special to get you started with a teeth cleaning, oral exam, and a set of x-rays. 

 We also have  a membership plan that starts at $365 per year for adults, and includes:

  • 2 comprehensive oral exams and cleanings with fluoride treatment
  • 1 set of x-rays per year
  • 1 emergency exam with x-rays per year
  • 1 set of full mouth x-rays every 5 years
  • 15% off all other treatments including periodontal maintenance

With this plan, you can save a lot compared to paying out of pocket, and enjoy affordable care without dental insurance. 

Contact Waterfront Dental To Get The Dental Care You Need In Baltimore

Dr. Dawn Merguerian is dedicated to conservative, holistic, cost-effective care in Baltimore, and our team is here to help you regardless of your insurance status. Contact us online or call us at (410) 505-0551 to schedule an appointment right away.

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