dental insurance made simple

Dental insurance can be confusing, with every service falling into a different category or code. At Wall Street Dental Group, we translate insurance language into plain words so you always know how your plan works and what to expect.

Most insurance providers divide coverage into three main areas: preventive, basic restorative, and major services. Preventive care, like exams, cleanings, fluoride, and X-rays, is often fully covered because it helps reduce long-term costs for both you and the insurer. Basic restorative services, such as fillings, simple extractions, and root canals, are usually covered at a percentage. Major services, like crowns, bridges, dentures, and implants, often require higher out-of-pocket contribution and may have waiting periods.

Most plans also include an annual maximum, which is the highest amount your insurer will pay in a year. Preventive benefits typically do not roll over, so skipping a cleaning can mean missing out on coverage you’ve already paid for. Deductibles may apply before coverage begins on non-preventive care, and each plan has its own rules about frequency limits, waiting periods, and covered services.

During your first visit, our administrative team reviews your insurance information, checks your eligibility, and provides a personalised benefits breakdown. We explain how your deductible, annual maximum, and coverage percentages apply to your treatment plan so you can make informed choices without surprises.

Planning care around your benefits helps you get the most out of your coverage. For example, if your annual maximum is nearly met, we may schedule some treatment after your plan renews. Families can also coordinate coverage across children’s cleanings or orthodontic care to make sure everyone receives the care they need in a manageable way.