How Does Dental Insurance Work San Luis Obispo, CA
Many people are unaware of how dental insurance works. Fortunately, dental insurance plans are more straightforward and easier to understand than health insurance plans. Our team can help you learn about dental insurance plans, options, and how to make informed decisions about your oral health.
At Islay Hill Dentistry Co., we accept various dental insurances. If you are in San Luis Obispo and the surrounding area, call us today at (805) 316-4968 to schedule an appointment or learn more about our accepted dental insurance plans.
Shopping for Dental Insurance
When choosing dental insurance, many people want the insurance plan to include their current dentist. Most providers have websites with a directory of dentists within their network.
One can visit their dental insurance carrier's website to search for their dentist's in-network status. If their dentist is not within the network, patients can shop around for a different dental insurance provider. Alternatively, they can select a dentist in-network that accepts their insurance.
“When choosing dental insurance, many people want the insurance plan to include their current dentist.”
Coverage for Dental Procedures: Types of Coverage Available
Plenty of options exist for dental insurance. This can be good, as plans cater to a wide range of needs. The types of coverage, premiums, and deductibles can vary — which can be confusing.
Consider the following when choosing dental insurance:
Find Out What Plans are Available in Your Area.
Start by narrowing your search to dental plans available in your city and state. Some insurance companies do not offer coverage throughout the United States, so keep things simple by comparing plans available in your area.
Look for a Plan that Has Many Dentists and Dental Practices.
Whether one currently has a preferred dentist or not, it is essential to consider having more than one option. An insurance company that covers many dentists and providers typically remains in good financial standing with a solid reputation — meaning that claims will likely be reimbursed on time.
Consider All Costs.
When searching for a dental insurance provider, patients should first consider the monthly premium and deductible. They should also consider the amount they will have to pay out-of-pocket for dental services (copays) before insurance kicks in.
The maximum annual limit is also essential to note. Most insurance companies put a cap on the amount they will reimburse each year. Once this cap has been reached, all the patient's dental expenses will be out-of-pocket. Patients should pay particular attention if they have extensive dental issues that need to be addressed.
Most routine dental treatments remain covered under dental insurance, but many plans do not cover "extras," such as whitening or sealants. Check with the insurance carrier to learn about covered procedures. Also, be aware that some insurance plans have required waiting periods — leaving patients waiting a long time for coverage on specific procedures — especially the more expensive ones.
“Plenty of options exist for dental insurance. This can be good, as plans cater to a wide range of needs.”
Purchasing Dental Insurance
Purchasing dental is a personal issue and depends on how much dental work the patient needs and how many family members they have. Generally, the more dental work required and the more family members, the more value for the month.
The typical dental insurance plan covers preventive care: checkups and cleanings at 100% (no deductible), basic procedures (e.g., fillings and extractions) at 70%, and major procedures (e.g., crowns and bridges) at 50%. Some procedures may be considered basic by one carrier and major by another, so patients must speak with their insurance carrier before getting dental treatments to understand the breakdown of costs and coverage.
Like health insurance plans, dental plans typically have a deductible — the amount one has to pay out of pocket each year before the plan starts to cover its portion of costs. Most plans cap the total amount they will pay for care per plan member per year. Any dental expenses over the plan's cap (or maximum) become the patient's responsibility.
“Purchasing dental is a personal issue and depends on how much dental work the patient needs and how many family members they have.”
Check out what others are saying about our dental services on Yelp: How Does Dental Insurance Work in San Luis Obispo, CA
Family & Individual Dental Insurance
Oral health coverage does not come as "one size fits all." Some may need insurance only for themselves, whereas others may be in the market for insurance for the entire family.
Patients can purchase individual dental insurance plans through the marketplace (U.S. government) when selecting their health insurance coverage or directly purchased through the carrier. Premiums for individual plans tend to be lower than family plans as only one individual is covered.
Family dental insurance plans cover the entire family and typically have higher premiums as more people seek coverage. Most family plans have allowances for two exams annually per plan member. Patients should find the right blend of insurance coverage that matches the entire family's oral care needs while still being affordable.
“Oral health coverage does not come as ‘one size fits all.’ Some may need insurance only for themselves, whereas others may be in the market for insurance for the entire family.”
Questions Answered on This Page
Q. How can I know if my dentist accepts my insurance?
Q. What should I look for when choosing dental insurance?
Q. Is dental insurance worth it?
Q. What is the difference between family and individual dental insurance?
Q. How can I find an affordable dental insurance plan for my family and me?
People Also Ask
Q. What factors should people consider when choosing a dental insurance plan?
Q. What is a health savings account?
Q. Who is the billing specialist?
Q. Why is preventative care important? How can it save you money?
Choosing Dental Insurance
Purchasing dental insurance can be an overwhelming experience. Luckily for many people, the plan offered by their employer or professional association is the best possible option. Still, in many cases, it may be useful for patients to talk to their dentists to see what plans they accept.
Many dental offices can recommend affordable plans that cover their patients' needs. Patients should look for a policy with a high spending cap if they know they will need major work done, while patients who require less work done can look for a policy with a lower spending cap.
“Many dental offices can recommend affordable plans that cover their patients’ needs.”
Frequently Asked Questions
Q. Can I be covered under multiple dental insurance plans?
A. You may, but one plan will probably be considered your primary plan. If this is the case, the primary plan will go toward your dental care first, with the other plan(s) covering the remaining costs. However, the plans cannot cover more than 100% of the treatment cost.
Q. What are the different kinds of dental plans?
A. Like health insurance plans, dental insurance plans are generally categorized either as Indemnity (e.g., HMO) or managed-care (e.g., PPO) plans. These plans mainly differ in the patient's choice of providers, how expenses are paid, and out-of-pocket costs.
Q. Why is dental health important?
A. Many people mistakenly believe that dental health is isolated from overall health. In reality, each system of the body is interrelated. In other words, neglecting your oral health could easily have disastrous effects on your overall health.
Q. Do I really need a dental insurance plan?
A. Yes. It can be costly to keep up with dental health, especially if you are making your routine checkups and cleanings as directed. Choosing the right dental insurance plan can help keep costs low while promoting proper healthcare.
Q. Whom should I talk to about any questions I have about my dental insurance plan's benefits or a claim?
A. It is best to directly contact your insurance carrier for any questions and concerns about your benefits or claims.
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Dental Terminology
Call Us Today
If you have questions about dental insurance options or whether or not a service is covered, call Islay Hill Dentistry Co. in San Luis Obispo at 805-316-4968 to learn more.
Helpful Related Links
- American Dental Association (ADA). Glossary of Dental Clinical Terms. 2025
- American Academy of Cosmetic Dentistry® (AACD). Home Page. 2025
- WebMD. WebMD’s Oral Care Guide. 2025
About our business and website security
- Islay Hill Dentistry Co. was established in 2019.
- We accept the following payment methods: American Express, Cash, Check, Discover, MasterCard, and Visa
- We serve patients from the following counties: San Luis Obispo County
- We serve patients from the following cities: San Luis Obispo, Arroyo Grande, Atascadero, Pismo Beach and Shell Beach
- CA (License #63695). View License Information and Specifics
- National Provider Identifier Database (1356721807). View NPI Registry Information
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