Harmony Dental Insurance Coverage and Costs Explained

Harmony Dental insurance plans offer a range of coverage options to suit different needs and budgets.

You can choose from three main plan types: Basic, Standard, and Premier. Each plan has its own set of benefits and costs.

The Basic plan is the most affordable option, with a lower premium but fewer benefits. It's a good choice for those who only need routine care.

The Standard plan offers more comprehensive coverage, including some major services like crowns and root canals.

Dental insurance covers a wide range of treatments, from cleanings and exams to fillings, root canals, and dentures.

Preventative care is usually covered at or close to 100%, while major and basic services are covered between 50-80%.

You may have to cover the cost out of pocket if your dental treatment is only partially covered by your plan.

We accept most dental insurance companies, including MetLife, Cigna, United Healthcare, Delta Dental, Aetna Dental, Blue Cross Blue Shield, UMR, Principal Life, Beam, United Concordia, Dentaquest, and Medicare Dentist.

Here's a list of some of the most common dental insurance providers we work with:

You'll receive a detailed treatment plan with an itemized insurance estimate included, so you can see what your insurance is expected to cover compared to the total treatment price.

Insurance companies draw a line at wholly cosmetic procedures, which means you may have to pay out of pocket for these services.

At Harmony Dental Group, you'll receive a detailed treatment plan with an itemized insurance estimate, making it easy to understand what your insurance covers.

This way, you can compare the expected insurance coverage to the total treatment price for procedures like fillings, crowns, or implants.

Your La Jolla dentist will also offer alternative treatments to consider, so you can budget accordingly and make an informed decision.

Your dental insurance plan likely has a maximum yearly dollar amount for benefits, which means you'll have to pay anything over and above that amount.

This maximum is usually very high, even for affordable policies, so you don't have to worry about hitting it anytime soon. However, if you need a lot of dental work, you can usually spread your care over two years to avoid hitting the maximum.

You'll also have to pay a portion of the bill from the dentist, known as co-pays. These can be a nominal amount or a larger portion of the bill, depending on your policy.

Here's a rough idea of what you might expect to pay out of pocket for different types of treatments:

Keep in mind that these are just rough estimates, and your actual costs may vary depending on your policy and the dentist you visit.

Deductibles can vary greatly depending on your insurance plan. Some plans have a hard dollar figure for your deductible, which is calculated throughout your payment period.

Your deductible might be yearly, meaning you'll have to meet it before your insurance covers your bills. Routine cleanings might be treated differently than an emergency root canal.

Not all plans make you pay your entire deductible before insurance kicks in. Some plans apply deductibles differently to different dental services.

You'll receive a detailed treatment plan with an itemized insurance estimate at Harmony Dental Group, so you can see what your insurance covers compared to the total treatment price.

Our La Jolla dentist will also offer alternative treatments worth considering, so you can compare them to one another and budget accordingly.

Insurance companies typically exclude wholly cosmetic procedures from coverage, but you can include them with the proper policy if you're willing to pay a little more.

It's essential to have your health insurance broker explain any exclusions on your policy to avoid disputes and misunderstandings when you receive dental care.

Your dentist is a partner in maintaining your oral health, and understanding how they work with your insurance is key to getting the care you need.

Routine cleanings and exams are usually covered at or close to 100% by your dental insurance plan. This is because preventative care is a top priority.

If you do need treatment, your insurance coverage will drop a little, but restorations like fillings may be covered at around 75-80%. This varies depending on your plan.

To get an estimate for dental work, you may need to ask your dentist office for a pre-treatment estimate, especially if you're having a lot of work done. This is a standard practice for complex treatments.

You'll also want to plan for meeting your deductible and remembering your maximum allowable amounts, which are how much your insurance will cover each year. For example, you might have up to $1,500 a year in dental benefits after you've paid your deductible.

Dental financing is a payment option for those who can't afford dental care upfront. It's usually more affordable than using a separate credit card or private loan.

You can use dental financing for medically necessary treatment, major dental work, or elective services like braces or a smile makeover. Many patients pay back their balance with no interest at all.

Financing allows you to schedule treatment today instead of months from now. This is especially important for conditions like active tooth decay or gum disease, which can become more expensive to manage over time.

We'll provide an itemized breakdown of the services needed, the steps involved, and the fee for each one when creating your treatment plan. This helps you understand exactly what you're paying for.

You can then choose to finance all or a portion of the remaining balance based on your budget and personal preferences.