Jonesboro, AR — (JonesboroRightNow.com) — March 11, 2025 — Dental insurance can be a valuable tool in making oral healthcare more affordable, but understanding how it works can sometimes be confusing.

If you have dental coverage, knowing the basics of how it applies to your treatments can help you make the most of your benefits while avoiding unexpected costs.

In-Network vs. Out-of-Network Coverage

One of the first things to consider when using dental insurance is whether your provider is in-network or out-of-network with your plan. Choosing an in-network dentist means you’ll benefit from pre-negotiated rates, which typically results in lower out-of-pocket expenses. At Higginbotham Family Dental, we work with many major insurance providers, making it easier for patients to maximize their benefits while keeping costs down.

If you visit an out-of-network dentist, your insurance may still cover part of the treatment, but you may have to pay more out of pocket. It’s always best to verify coverage before scheduling an appointment.

Understanding Coverage Levels

Most dental insurance plans categorize services into three main tiers:

  • Preventive Care – Includes exams, cleanings, and X-rays. These services are usually covered at 100%, meaning there’s no cost to you.
  • Basic Services – Treatments like fillings, extractions, and simple procedures typically fall under this category and are often covered at 70-80%, meaning you pay the remaining portion.
  • Major Services – Crowns, bridges, dentures, and more complex procedures generally have 50% coverage, leaving you responsible for the other half of the cost.

Each plan varies, so it’s essential to check with your provider to understand what your specific policy covers.

Deductibles, Copayments, and Maximums

Like medical insurance, dental plans often include a deductible, which is the amount you must pay before insurance begins covering services. Additionally, a copayment or coinsurance may be required, depending on your plan.

Most dental insurance policies also have an annual maximum, which is the total amount the plan will pay for dental care within a year. If your treatment costs exceed this limit, you are responsible for the remaining balance.

Filing Claims & Making the Most of Your Benefits

At Higginbotham Family Dental, we simplify the insurance process by filing claims on behalf of our patients. This ensures that you receive the maximum benefits available under your plan. If you’re unsure what your policy covers, our team can help review your benefits and provide cost estimates before treatment.

To get the most from your dental insurance, schedule regular checkups and take advantage of preventive care, as this can help avoid costly procedures in the future. If you have remaining benefits, it’s a good idea to use them before the end of the year, as unused coverage does not roll over.

Understanding how dental insurance works can help you make informed decisions about your oral health while keeping costs manageable. If you have questions about your plan, our office is happy to assist you!

Click here to visit our insurance page to see who we are in network with.