We accept dental insurance plans
in Oshkosh

How to Use My Dental Insurance With a Dentist in Oshkosh

More than three-fourths of Americans have dental insurance, according to the National Association of Dental Plans. Most of these folks have private dental coverage, typically from a group program or an employer. Dental benefits are more likely to come from large employers rather than small ones; they’re also more likely to come with high-wage jobs than low-wage jobs. State Medicaid programs typically only cover pediatric dental care, while Medicare doesn't provide any dental coverage.

What benefits your dental plan offers you and what the plan costs you for those benefits depends in part on how you obtained the plan, whether:

• From an employer
• Through the health insurance marketplace
• Provided through state Medicaid
• Bought from an insurance company directly

Make the most of your dental insurance benefits. Call us to schedule an appointment with a Oshkosh dentist that takes insurance today.

Dental Insurance Basics

Dental insurance provides coverage to assist with the cost of certain dental care services. It can help you pay for some or all of the dental work your dentist in Oshkosh performs, whether routine dental cleanings or dental X-rays to more involved and extensive procedures and services like dentures or implants.

What Dental Plans Cover

While dental insurance has many similarities to health insurance, it typically has much lower premiums. However, there is a trade-off. Most health insurance plans typically have a yearly out-of-pocket maximum and cover a large portion of even high expenses after you pay the deductible; most dental plans, however, use the 100-80-50 structure for coverage.

When using an in-network dentist near me who accepts my insurance, a dental policy will typically pay for 100 percent of preventive care services including routine checkups, cleanings and X-rays. A dental policy will typically only pay 80 percent, however, of the cost of basic procedures like root canals, extractions and fillings. For more extensive procedures, like implants, bridges or crowns, a dental policy will typically pay only 50 percent.

Since orthodontic work and cosmetic dental procedures are not considered medically necessary, most dental policies simply won’t cover them at all; that means your out-of-pocket cost for such procedures could be significant.

Kinds of Dental Plans

There’s a range of dental plans available, including individual, family and group plans.

Indemnity Dental Policies

Indemnity policies are less common in the dental insurance marketplace and are generally the most costly dental plans. Also known as “fee-for-service” dental plans, they pay a predetermined maximum amount of money for various dental treatments and procedures. Any of the cost remaining after this policy pays its portion is your responsibility to pay out of pocket.

Preferred Provider Organizations (PPO)

This type of dental plan is among the most common available. PPO networks negotiate fee structures with the dentists who join them. If you use a dentist that accepts PPO insurance who’s in that network, your out-of-pocket cost is based on this negotiated price; if you use a provider outside of the network, your out-of-pocket cost will be far greater.

Health Maintenance Organizations (HMO)

With this type of dental plan, you pay a premium either monthly or annually for coverage, but are limited to only seeing a dentist that accepts HMO insurance and is within that HMO’s network.

Call our dental office in Oshkosh to discuss what your potential costs for care could be with and without insurance, though you’ll need to speak with your insurer directly to find out exactly how much of which procedures they’ll cover.

Understand Your Coverage

Be clear on what services your dental plan does and does not cover. Review your dental insurance policy closely, and contact your dental insurance provider to find out what your coverage includes. Understand what your plan will cover in normal preventive and basic care and what it will cover in emergency care.

Some examples of key procedures and treatments to consider when looking at which dentist takes my insurance:

• Exams
• Cleanings
• X-rays
• Fillings
• Tooth removals
• Root canals
• Gum cleanings
• Denture repairs

Make sure to find out, as well, whether there’s a waiting period from the time you purchase a dental policy until the time you can start receiving certain covered services or if you can schedule treatment immediately after purchasing the policy. For certain procedures, like periodontal disease treatment, crowns or implants, TMJ treatment and full dentures, you may have to wait until you’ve been covered for a full year under your plan before you can start receiving them.

Finding a Dentist Near Me Who Accepts My Insurance

At Dental Design Studio, we accept a variety of dental insurance plans. Call us to find out which dental insurance we accept. We promise to always try to make your dental care as affordable as possible, and we never recommend unnecessary procedures.

Insurances we accept

• Delta PPO
• Humana PPO
• Say Cheese Dental Network
• United Healthcare