Understanding Dental Insurance Deductibles: A Comprehensive Guide

A deductible is an amount you must pay on an insurance claim before your policy benefits kick in. In dental insurance, it is common to have an annual deductible for each individual on a policy, as well as for your family.

How the Deductible Works

Each policy has its own deductible requirements. Some deductibles apply to all covered dental procedures, while others apply to individual services such as crowns or root canals. If your first dental bill of the year is $200, you might have to pay the first $25 as a deductible before your policy benefits take effect. If you have an 80-20 coinsurance, you then pay 20 percent of the remaining balance of $175 after the deductible is satisfied. After you satisfy a deductible in a calendar year, you don't have to worry about it again until the next year.

Additional Deductible Details

Many dental insurances don't require a deductible on routine preventative and diagnostic services. If you only visit the dentist twice during the year for routine cleanings and check-ups, for instance, you may never pay a deductible. If your family has a $75 deductible, the cumulative deductible from three family members meets your annual obligation regardless of whether additional family members need dental care. Premiums and copayments normally don't count toward a deductible.