What to Ask When Looking at Dental Benefits

askOpen enrollment for insurance plans usually starts in October. We’d like to provide our patients with some information about what to ask when looking at dental benefits. A key thing to remember is that dental insurance is not really insurance; it is a benefit. Dental benefits define how much will be covered UP TO a certain amount, regardless of the dental services rendered. Here are a few questions to ask your Human Resources (HR) Department or the insurance companies you are looking at.

Please know that we participate in the Delta Dental Premier Network, Cigna DPPO Total Network, and Grid+ Network.

  1. Can I go to any dentist I choose?
  2. Can I go to an out-of-network dentist and still have my services covered?
  3. How much will this plan pay for the following codes, and does the deductible apply?
  4. D0150=Comp exam
    D0120=Periodic exam
    D1110=Adult prophy
    D1120=Child prophy (to age 14)
    D0274=4 X-rays
    D0220=Periapical X-ray
    D2740=Porcelain crown
    D2740=Porcelain crown
    D7210=Surgical extraction
    D2160=3 surface amalgam filling
    D2332=3 surface composite filling

  5. Are exams and cleanings covered twice per year (less than 6 months apart) or once per 6 months?
  6. How often are X-rays covered?
  7. For Delta Dental & Cigna Plans:

  8. Does my employer have their own fee schedule or is payment based on the doctor's contracted in-network fee schedule?
  9. Can I go to any Delta Dental Premier/Cigna DPPO Total provider, or am I limited to certain ones?

Gilmore Family Dentistry

  • Gilmore Family Dentistry - 1759 Creighton Rd., Pensacola, FL 32504 Phone: (850) 476-4283

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