How To Make The Most Of Pediatric Dental Insurance

If you have a family dental insurance plan or dental insurance specifically for your children, you may be wondering how you can maximize your benefits and keep your out-of-pocket costs low. In this guide from Cavity Patrol Pediatric Dentistry, we’ll discuss a few things you should know. 

1. Find An In-Network Pediatric Dentist For Your Kids

First, you should make sure you find a pediatric dentist in Cypress that is in-network with your insurance. This will reduce your out-of-pocket costs. We work with a wide variety of providers including BlueCross BlueShield & Unicare, Cigna DPPO, Delta Dental, Careington, and many others. Give us a call at (832) 305-6507 to make sure we accept your insurance.

2. Understand Your Pediatric Preventive Dental Coverage

Kids are always covered for 2 preventive visits per year, as well as a set of annual x-rays. In addition, children under the age of 18 can usually also get coverage for additional preventive treatments such as dental sealants and fluoride treatments to prevent cavities. Consult with your plan information to check your child’s coverage, and make sure you use it to the fullest extent possible! 

3. Get Familiar With The 100-80-50 Coverage Model

Most dental plans for all ages work using a 100-80-50 coverage scheme. Basically, this means that:

  • Your plan covers 100% of the cost of preventive care. This includes routine checkups and x-rays.

  • Your plan covers 80% of the cost of “basic” care. This typically includes fillings and root canals, along with some other procedures. 
  • Your plan covers 50% of the cost of “major” care. This is usually defined to include dentures, dental bridges, and crowns. 

This is another reason why good at-home oral care and frequent preventive visits to Cavity Patrol Pediatric Dentistry are so important. Keeping your child’s mouth healthy will reduce your out-of-pocket costs for restorative dentistry. 

4. Consider Your Annual Maximum & Yearly Deductible

The majority of dental plans have a deductible, usually between $25 and $250. Like medical insurance, this is the threshold you must meet before your plan covers the cost of treatment.

There is also an annual maximum, which is usually set between $1,000 and $2,000. After your plan pays out to this limit, it will no longer cover your child’s care.

Sometimes, you can plan around this. For example, if both of your kids need fillings near the end of the year, you may be able to get the most important fillings in December, then plan the remaining treatment for January of the following year, since most dental plans “roll over” on January 1st.

Get Your Child The Dental Care They Need In Cypress & Katy

Preventive care is the best way to save money and time, keep your child’s mouth healthy, and get peace of mind. And even if you don’t have insurance, we’re here to help your little one. We offer free first-time visits for kids under the age of 3, and a $99 New Patient Special for kids who are over the age of 3. 

With reasonable costs and financing available, Dr. Julia and Dr. Chun always do their best to provide affordable care in Cypress and Katy. Contact us online or call at (832) 305-6507 to schedule an appointment and get started now. 

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