How Can I Best Use My Dental Insurance For My Kids?

If you have a family dental insurance policy, you may be wondering how you can maximize its benefits, particularly if you have one or more kids. Get some top tips and advice in this blog from We Care Dental Care now.

1. Get Two Checkups For Your Kids Per Year

Almost all dental plans cover 100% of the cost of two checkups per year for you and your kids. That includes teeth cleanings, oral exams, and usually an annual set of x-rays. To make the most of your plan, schedule checkups twice a year for all of your family members. 

2. Check For Coverage For Dental Sealants & Fluoride Treatments

Children under 18 usually get coverage for dental sealants and fluoride treatments, which are often 100% paid for by your dental insurance policy. We recommend checking your policy for more information. Both of these preventive treatments are excellent at preventing cavities. 

3. Understand The Common 100-80-50 Coverage Scheme

Most dental plans require a certain amount of “coinsurance” for your child’s procedures. This varies depending on the type of care, and usually uses the 100-80-50 model, where:

  • Your plan pays for 100% of the cost of preventive care, such as the six-month checkups and pediatric fluoride treatments/sealants mentioned above
  • Your plan pays for 80% of the cost of basic care, like fillings for cavities or a root canal for an infected tooth
  • Your plan pays for 50% of the cost of major care, which usually includes dental crowns and most oral surgeries

This is yet another reason your child’s oral health is so important. The better you care for their smile, the less you’ll pay out-of-pocket, since you can avoid common issues like cavities and infected teeth. 

4. Find An In-Network Dental Provider

In-network dental providers will always provide care at a lower cost, since your insurance will cover more of your child’s treatment. At We Care Dental Care, we’re in-network with Aetna, Ameritas, Anthem, BlueCross BlueShield, Cigna, Delta Dental, and MetLife. Feel free to call at (540) 724-6335  to make sure we work with your insurer! 

5. Be Aware Of Yearly Deductibles & Annual Maximums

Dental plans usually have a yearly deductible between $25 and $250, and this is how much you must spend on your family’s dental care before your plan’s benefits begin to pay out.

Similarly, most plans also have an annual maximum of between $1,000 and $2,000 for your entire family. This is the maximum they will pay out in a given benefit period, which usually “rolls over” on January 1st each year. 

Often, it’s possible to plan around this if you have multiple kids. One child can get fillings in December of one year, for example, with another child getting treatment in January when your annual maximum resets. At We Care Dental Care, we’ll always try to plan and maximize your benefits. 

Make The Most Of Your Dental Plan And Keep Your Child’s Smile Healthy 

Hopefully, the above tips will help you keep your child’s smile healthy and ensure you maximize your dental plan’s benefits. Even if you don’t have insurance, though, we’re here to help. Dr. Burkitt provides cost-effective care in Roanoke, and our $99 New Patient Special will help your little one get started at our office for less. Contact us online or call at (540) 724-6335 to get started.


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