Medical and Dental Insurance Work Differently; Here’s How

April 14, 2025

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After enrolling in your company’s benefits program, it’s a great idea to schedule your next dental checkup. However, it can be quite frustrating to discover that the medical insurance you purchased does not cover oral health care, and you might wonder why medical and dental insurance are separate. Here’s a brief guide to the differences between medical and dental coverage as well as a few reasons why you should attend regular dental checkups.

How Does Medical Insurance Work?

While medical insurance frequently pays for routine care such as checkups, it is also designed to cover unexpected emergencies. This is because sudden accidents, infectious diseases, and cardiovascular events are often impossible to predict, and medical insurance serves to create a financial safety cushion in case of an unanticipated crisis.

How Does Dental Insurance Work?

The oral health crises and infections treated by dentists are typically much more predictable and practical to prevent than most medical emergencies. For example, tooth decay, gum disease, and other oral ailments typically take a significant amount of time to develop, and detecting them early during a routine dental appointment can prevent much suffering as well as the expense of treating advanced infections.

To keep rates low, dental insurance companies typically cover preventative care completely so that patients are encouraged to receive frequent checkups. These appointments allow dentists to correct problems in their early stages and recommend better at-home oral care methods. Restorative care is typically covered by about 50%, and there are typically limits on how much insurance companies will pay for emergency dental services.

How Can I Get the Most out of My Dental Insurance Policy?

You pay good money for your dental insurance, so it only makes sense that you would want to see a significant return on your investment. When searching for an oral healthcare provider, be sure to find an office that is in-network with your insurance. During your appointment, your dentist will thoroughly inspect your teeth and soft tissues for signs of trouble, treat any issues they find, and help you understand how you can take better care of your smile at home.

Regular dental care from a qualified professional is crucial to preserving the health and beauty of your smile for life. Understanding how your dental insurance policy works can take a lot of stress out of finding a dentist and help you keep your grin in great shape.

About the Practice

Ridgefield Perfect Smile Center provides the most excellent oral healthcare in town. Led by Drs. Dana C. Jones, Josephine A. Franzese, and Joseph S. Roberti, the staff ensures that each patient enjoys courteous service and sincere compassion in a clean and friendly office environment. Areas of expertise include general, restorative, cosmetic, and emergency dentistry, and the office welcomes Cigna PPO plans as well as Delta Premier and Anthem Complete. To learn more about how dental insurance works, contact the practice online or dial (203) 438-8919.