Understanding Dental Insurance Limitations

For those with dental insurance, the amount of coverage depends upon the specific policy. Almost all dental insurance policies contain limitations that require that patients pay a portion of their own dental costs.

Annual Limits

Depending on the policy, a dental insurance provider may place limits on the amount of coverage each family member receives throughout the year. For example, a policy may limit you to receiving no more than $1,000 worth of coverage each year. In this scenario, you are liable for any dental charges in excess of the covered amount. Limitations may also apply to families as a whole, rather than a single individual.

Services Not Covered

Some dental plans specify that certain dental services are not covered under the plan. Orthodontic services and cosmetic dentistry are two common examples of care that many dental insurance plans do not cover.  

Preferred Providers

Your dental insurance policy may only cover dental services when those services are provided by a specific dentist--excluding certain dental practices entirely. Dentists whose services are covered under the plan are known as “preferred providers.” In some cases, your dental insurance provider may provide coverage for all dentists, but provide you with an added discount for seeking your dental care from a preferred providers.