Medically reviewed by Dr. Michael Moulton, DMD
Before you book a dental visit, one of your first questions is often whether your insurance works there. The answer depends on your specific plan, and dental benefits can look vastly different from one employer to the next. Many patients with coverage are able to use their benefits, and patients without coverage have a simple alternative, so you have options either way.
At Lexington Family Smiles, we provide comprehensive care for the whole family, from general and preventive dentistry to restorative treatment. Here is how we work with dental plans, what to check before your visit, and what you can do if your coverage falls short.
We participate in insurance through a dental advocacy group, which means we work with a select group of plans rather than every plan on the market. Because coverage varies so much, the best first step is to share your plan details with our office so our team can check your benefits before you come in.
It also helps to know how your plan is built. Most plans set an annual maximum, which is the most the plan pays toward your care in a calendar year. The American Dental Association notes that many plans still cap yearly benefits at amounts set decades ago, and patients often cover a larger share of costs as they near that limit. For example, a plan may pay a higher percentage of preventive visits than of crowns or other restorative work, so two treatments can leave you with very different out-of-pocket costs. The following details make your benefits check quicker, so it may help to have these ready:
With those details, our team may be able to give you a clearer picture of your expected costs before treatment begins. If you work for Lexington County School District One, see our guide to dental care for Lexington County School District One employees in Lexington, SC for how PEBA’s Basic Dental and Dental Plus plans may apply.
If we do not participate with your plan, you may still have out-of-network benefits that help pay for a portion of your care. Policies differ, so ask your plan administrator what they cover when you see a provider outside their network.
For costs insurance does not cover, our financing options through CareCredit, Cherry, and Sunbit may let you spread the balance over time. Each provider sets its own terms, repayment timelines, and eligibility requirements, and our team can walk you through them before you decide.
A quick benefits check before your first visit helps you plan with fewer surprises. Share your plan details with our team, and we can let you know how your coverage may apply to the care you need, whether that is a routine dental exam and cleaning or a larger treatment plan.
If you are self-employed, retired, or do not have dental coverage through work, our Dental Savings Plan is an in-house membership you can use instead of insurance. It is not insurance, so there are no claim forms to manage.
Each membership includes:
Cosmetic dentistry and braces are not included.
Our neighborhood practice is built around comprehensive family care, from children’s cleanings and exams to restorative dentistry for grandparents, all under one roof. Whether you have insurance, a membership, or a financing plan, our team will help you find a care path that fits your family. Contact our office today to schedule an appointment and experience comprehensive, compassionate general and preventive dentistry in Lexington, SC.