What is a Deductible?

A deductible is the amount you must pay out-of-pocket for dental services before your insurance begins to cover costs within a specific period of time or benefit period, e.g., a calendar year. This usually applies to basic and major services but not to preventive care.

A deductible is applied over a 12-month period, not to each dental treatment.

Examples:

• If your deductible is $50, you must pay $50 out-of-pocket before your insurance covers any part of the service cost. Let’s say you need a filling for $150. You’d have to pay $50 before the insurance will pay a portion of the remaining $100.
• Once you have met your deductible, you will not need to pay it again for other basic or major dental services in the same benefit period, usually a calendar year. If, after meeting your deductible, you need a root canal that costs $1,000, and your insurance covers 80%, you would pay the remaining 20% or $200.

FAQs

• Do all services require a deductible? No, preventive services often do not require a deductible and are covered at 100% if provided by a network dentist.
• Do I have to pay a deductible for every basic or major dental procedure? No. The deductible applies annually. Once you have met it (paid it) for the benefit period (plan year), it doesn’t apply to any other dental care treatments you might need in that period.
• Is the deductible annual? Yes, most deductibles reset annually, meaning you must meet the deductible amount each benefit period, e.g., a calendar year.

Example of a Deductible

This chart shows an example of how a deductible is applied to the preventive and restorative dental care a patient might require during the benefit period, here: January through December.

Delta Dental of Arkansas Offers Dental and Vision Insurance for Individuals and Groups

Are you interested in our dental coverage plans so you don’t have to pay the full dentist bill yourself? Check out our insurance options for individuals and families, and small, mid-size and large groups.

And while you’re browsing, take a look at our vision insurance, too.

More Dental Insurance Terms Explained

1. What is a premium?
2. What is a waiting period?
3. What is a network dentist?
4. What is a benefit period?
5. What are preventive/diagnostic, basic and major dental procedures?
6. What is a deductible?
7. What is a copay?
8. What is co-insurance?
9. What is an annual maximum?
10. What is a claim?
11. What is an explanation of benefits (EOB)?
12. What is a pre-determination of benefits?
13. What are out-of-pocket expenses?

Back to Dental Insurance Terms Explained: A Quick Guide

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