Dental vs. Medical Insurance
Dental insurance works very differently from medical insurance. Instead of protecting you from large, unexpected bills, it is designed to make routine and predictable dental care more affordable. The easiest way to think about dental insurance is to view it as a helpful coupon that reduces the cost of common services rather than full financial coverage.
Dental Insurance Acts More Like a Coupon
Most dental plans include an annual maximum, usually between 1,000 and 2,000 dollars. Once you reach that amount, you pay the rest out of pocket. Medical insurance does not work this way and is focused on covering major, unexpected medical expenses.
Prevention First
Dental insurance typically covers cleanings, exams, and X-rays at or near 100 percent to encourage preventive care. Medical insurance covers prevention too, but its main purpose is to protect you during serious health events.
More Cost Sharing
For fillings, crowns, and other procedures, dental insurance usually covers only a portion of the cost. Medical insurance generally covers more once your deductible and out-of-pocket maximum are met.
Predictable vs. Unpredictable Needs
Dental care is fairly predictable over a lifetime, which is why dental insurance is structured around maintenance. Medical care is less predictable, so medical insurance is structured around high-cost protection.
If you are wondering how to know if a dentist is in your plan, the best approach is to check your insurer’s website or call the dental office. Gawlas Family Dental can verify your benefits and explain your coverage.
The Difference Between PPO and EPO Plans
When choosing dental insurance, you will often see PPO and EPO listed as options.
PPO (Preferred Provider Organization)
This plan offers the most flexibility, allowing you to get reimbursed by in network and out of network dentists.
EPO (Exclusive Provider Organization)
This plan typically has lower premiums, but you must go to an in network dentist to receive any benefits.
Insurances Accepted at Gawlas Family Dental
We participate with several major insurance plans to make dental care accessible to more patients. These include:
- Aetna Extend
- United Concordia Elite
- Delaware Child Medicaid
If you need a dentist accepting new patients, our team is ready to help confirm your benefits and answer questions.
What to Do If You Do Not Have Dental Insurance
Not having dental insurance should not stop you from receiving the care you need. Gawlas Family Dental offers the Smile 365 Dental Discount Plan, which is a budget friendly membership designed for patients without insurance.
Smile 365 keeps you smiling the whole year long, providing access to savings on preventive visits along with discounts on many common procedures. It is ideal for anyone looking for the best dentist for someone without insurance or for families who want predictable and affordable dental care.
Why Gawlas Family Dental Is a Great Choice
At Gawlas Family Dental, we focus on compassionate, patient centered care for individuals and families. Our office offers a comfortable environment and modern treatment options, and we are always welcoming new patients.
Whether you use dental insurance, want help understanding your coverage, or plan to enroll in our Smile 365 program, our team is here to support your oral health. To schedule an appointment, visit our contact page.
