Dental insurance helps pay for treatments like cleanings, fluoride applications, fillings, and oral surgery that improve the overall health of teeth and gums. For most people, going to the dentist isn’t exactly the most exciting activity. With so much uncertainty surrounding cavities and unforeseen costs but going to the dentist is actually a crucial component of maintaining optimal health and enrolling in a dental insurance plan can help with controlling costs, bringing more peace of mind.

Taking the time to ask these questions will help you understand dental insurance benefits and the procedures will cover to give a beautiful and healthy smile.

What type of cleaning is covered?

  • Many patients think their insurance will cover two "free cleanings" a year. However, many insurance plans will only cover the cost of a healthy-mouth cleaning. If you're part of the 75% of the American population with periodontal (gum) disease, then you need to ask your insurance plan if it will cover your treatment.
  • The insurance company will cover the costs of your visits for periodontal disease management. Your dentist's office can give you the American Dental Association (ADA) codes to give to the insurance company to make sure you know the exact out-of-pocket costs associated with any procedures.

Is there a waiting period for major procedures?

  • Some people sign up for dental insurance because they know they need a crown, implant, denture, or another major procedure done.
  • Some insurance plans require to have coverage for a year before they cover the costs of even an emergency treatment like a root canal.

What type of filling is covered?

  • The amount of tooth decay is more than what a regular filling can replace but less than what would require a crown to repair, then your dentist may recommend an inlay or onlay.
  • Both are well-suited for large cavities, but they are more expensive than regular fillings. Ask your insurance company if it will cover the expense.

What materials are covered for major procedures?

  • Ask whether the insurance company pays only for non-precious metal or semi-precious metal crowns. These crowns often carry a warranty of one year or less and can cause dark lines around the gums.
  • Dentists may prescribe a higher-quality, more durable precious metal or all-ceramic crown based on the location of the missing tooth and expected wear.

Will insurance cover all the treatment associated with the procedure you need?

  • Call your insurance company and go through each step that is outlined. Many insurance companies will not cover the cost of the fluoride treatment, which remineralizes the teeth and helps prevent cavities.

Is there a missing tooth clause?

  • You may sign up for dental insurance because you have a missing tooth, which if left empty, can cause your other teeth to shift, affect your bite, lead to bone loss and cause your facial muscles to sag, which makes you look older.

Will a specialist's fees be covered?

  • Your insurance company may cover a procedure performed by a general dentist at one rate, and the same procedure performed by a specialist dentist at a different rate.
  • It’s important to know what percentage of your cost will be covered should you need to see an oral surgeon, endodontist, periodontist, orthodontist, or pediatric dentist.

Is there a deductible and/or a co-pay

  • Insurance company about co-pays or deductibles before you visit the dentist. Your out-of-pocket fees depend on the type of policy your employer has negotiated with the dental insurance company.

Methods of Affording Dental Care

The Cost of Dental Insurance

  • The average American pays about $360 a year for dental insurance, but it’s wise to get estimates before you make plans.
  • This is because there are a lot of different dental insurance companies out there, so the cost of each plan and the coverage it offers can vary widely.

The Pros of Dental Insurance

  • A lot of different insurance plans that can offer you varying levels of coverage, most dental insurance plans fit a basic mold.
  • Cover preventive care in full, which includes treatments like your twice-yearly dental cleaning, annual x-rays, and oral cancer screenings.
  • Enables to stay on top of dental problems before they become major—and more expensive—health issues.
  • Levels of coverage mean that when you do experience a major oral health concern, you don’t have to worry about paying the full cost of most types of treatment.
  • Dental insurance can greatly reduce your overall bill, making an otherwise expensive treatment affordable, and helping you to get the prompt treatment you need.
  • Versatility and wide range of options that dental insurance provide means that you can seek out a plan that fits both your oral health needs and your budget.

The Cons of Dental Insurance

  • Like anything, dental insurance has a few cons. One of the biggest cons is that it doesn’t cover all types of dental treatments.
  • It won’t cover treatments that the company considers elective or optional, even if there are real benefits to getting the treatment; for example, cosmetic dentistry treatments like tooth whitening and porcelain veneers aren’t covered by dental insurance.
  • Many insurance companies still consider dental implants to be a cosmetic treatment despite their many oral health benefits, implants often aren’t covered at all.
  • Starting to change, however, so it’s wise to check this issue specifically when you’re looking at insurance plans. Some dental insurance plans have a deductible.

What Procedures are Covered by Dental Insurance?

Most dental insurance plans cover the following procedures:

  • Dental exams and cleanings every six months
  • Dental x-rays
  • Dental crowns
  • Bridges

Why do you need dental insurance?

Generally, dental policies cover some portion of the cost of preventive care, fillings, crowns, root canals, and oral surgery, such as tooth extractions. They might also cover orthodontics, periodontics (the structures that support and surround the tooth), and prosthodontics, such as dentures and bridges.

iSmile Coral Gables and iSmile Doral, FL Payment Options


iSmile offers our patients many payment options. Our staff can help you arrange a suitable payment plan to fit your needs.

  • Convenient monthly payments
  • Coupons and monthly specials
  • All major credit cards accepted

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LendingUSA has pioneered an automated financing portal specifically created to help businesses grow. Their unique approach has created a true one-stop solution for your customers’ financing needs, offering an affordable financing option that allows them to quickly purchase the goods and services they want.

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American First Finance has High approval amounts, no money down options, and early payment options may be available. Approval is possible without a FICO score, but we may check credit history. Subject to approval and verification.

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We offer a variety of payment options to ensure you get the dental care you need.

iSmile by Dr. Sonia Olivares makes it easy to fit dental care into your budget. For your convenience, we accept cash, checks, and most major credit cards, plus offer financing to qualified applicants. Our dedicated team will help you understand all of the options available to you. Contact one of our staff to learn more about your billing and payment options today!

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