Dental Insurance Explained
Deductibles, maximums, waiting periods and why your plan covers cleanings but not crowns the way you expect.
The annual maximum
Most plans cap what they pay per year, commonly between $1,000 and $2,000. Unlike medical insurance, that cap has barely moved in decades.
The coverage tiers
Preventive care is typically covered at 100%, basic work like fillings around 80%, and major work like crowns around 50%. Percentages apply to the plan's allowed fee, not necessarily the full fee.
Deductibles and waiting periods
Many plans require a small deductible before benefits start and impose six to twelve month waits before covering major procedures.
How we help
We accept many PPO plans and can verify your benefits. We also give you a written estimate of your portion so there are no surprises.
Written by the team at Uptown Dentistry, led by Dr. Nicki Tajalli, DDS, in Uptown Houston. This article is general information, not a substitute for an exam.