Dental Insurance in San Juan Capistrano, CA

At Sila Dental, we work closely with our patients to offer quality, affordable dental care in San Juan Capistrano, CA. That’s why we also accept most major dental insurance benefits, reducing your out-of-pocket investment when it comes to oral health care. Our goal is to help you utilize your dental insurance coverage to keep your smile healthy for a lifetime.

What is Dental Insurance/Dental Benefits?

Dental insurance typically covers the cost or a portion of the cost for a dental procedure such as preventive care (cleaning), exams, x-rays, exam, fillings, and more.

Dental insurance is purchased separately from medical insurance, and depending on your oral health history, your treatment needs, and which dentist you want to see, dental insurance may not be worth the value you are paying for the insurance plan.

Which Treatments are Covered by Dental Insurance?

Dental insurance assists with coverage for a wide range of treatments, from cleanings and exams to fillings, root canals, and dentures. If your dental treatment is only partially covered by your plan, the remainder of the cost is out of pocket. In most cases, preventive care (for healthy gums) is covered at or close to 100%, with major and basic services covered somewhere between 50-80%.

Every dental insurance policy has an annual maximum and specific criteria that treatments must fit into if they are reimbursable by your insurance plan. If you have concerns about your coverage, it’s best to talk to your employer’s HR department to discuss the specifics of your policy and where it’s accepted.

Dental Insurance Accepted in San Juan Capistrano, CA

Our San Juan Capistrano, CA, dentist accepts most dental insurances, and we are happy to file claims on your behalf. If we are in-network, meaning we are contracted with a dental insurance company to provide services, the fees are typically easier to determine. Whereas if we are out-of-network, Sila Dental will provide you with an estimated fee breakdown based on what we expect your insurance plan to cover. However, we can typically accept all or most dental insurance plans, even if we are out-of-network.

Some of the insurance carriers that we work with include:

What if I’m Out of Network?

Even if we are out-of-network with your insurance, we will work with your insurance to reduce care costs. Although many insurance plans may restrict in-network benefits to certain providers, you can normally use your plan at out-of-network dentist’s offices as long as you pay the difference in the coverage and treatment fee.

To help you better make decisions and understand your care, Sila Dental will always print an itemized treatment plan that lists all fees and procedures included, along with your estimated insurance benefits and patient portion. That way, you know exactly what to expect prior to scheduling any treatment. Additionally, you can always choose to finance all or a portion of your procedure when necessary.

How Dental Insurance Works

Your dental insurance plan places an emphasis on preventive care, which helps keep your smile healthy between checkups. That’s why visits like cleanings (for healthy gums) and exams are usually covered by your plan at or close to 100%. Even services like fluoride and dental sealants—which help prevent tooth decay—are usually covered for kids.

When you need treatment, the coverage on your plan drops. Restorations like fillings may be covered at around 75-80%, depending on your plan (every company is different.) Major services like crowns or root canals may drop to 50% in some cases. The goal is to treat issues earlier when they’re more conservative and affordable to manage.

Additionally, you’ll want to plan for meeting your deductible and remembering your “maximum allowable” amounts. These amounts are how much your insurance will cover each year, up to a set dollar amount. For example, you might have up to $1,500 a year in dental benefits after you’ve paid your deductible. You can also choose to use FSA or HSA funds on anything that isn’t covered by dental insurance or finance those amounts instead.

How Much Does My Dental Insurance Cover?

Every patient at Sila Dental will receive a detailed treatment care plan with an itemized insurance estimate included. That way, if you’re planning to get a filling, crown, implant, or other procedure, you can see what your insurance is expected to cover compared to the total treatment price. When possible, our San Juan Capistrano dentist will also offer alternative treatments worth considering so that you can compare them to one another and budget accordingly.

No Insurance? No Problem!

Many of our patients do not have dental insurance and choose to finance their dental treatment. They are able to make affordable low monthly payments instead of enrolling in a separate insurance plan. Talk with one of our team members today to find out if you need dental health insurance, other options available to finance all of your dental treatment if you don’t have insurance, and how affordable payment options work.

Affordable Dentist in San Juan Capistrano, CA

Trying to figure out how to afford your dental care shouldn’t keep you from accessing the healthy smile you deserve. At Sila Dental, we’re committed to helping our San Juan Capistrano, CA receive quality dental care, regardless of what their insurance may or may not cover. Call us today to reserve your next appointment.

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Questions Answered on This Page

• What is Dental Insurance/Dental Benefits?
• Which Treatments are Covered by Dental Insurance?
• Accepted Dental Insurance Plans
• What if I’m Out of Network?
• How Dental Insurance Works?
• How Much Does My Dental Insurance Cover?
• Medicare/Medicaid Dentist
• What if I Don’t Have Insurance?

Related Topics

• Dental Financing