Diagnostic and preventive services are most frequently used services, and can help patients avoid more costly dental care resulting from advanced dental disease. HMO dental plans usually cover preventive services for little to no cost. PPO plans often cover between 80% and 100%, with the patient paying the remainder plus any deductible if the plan dose not waive it on preventive care services.

For diagnostic and preventive services as well as other types of procedures, the insurer will specify any frequency limitations and exclusions that apply to the coverage. Such as twice a year cleaning (one every six months) and one set of X-rays a year.  These limitations and exclusions are designed to prevent fraud and abuse, and protect patients against over-treatment.

Be sure to review your plan booklet to learn about these guidelines and what your estimated share of costs will be. If you are not certain about any aspect of your coverage, insurers usually offer easy to understand benefit summaries online, or you can contact your carrier’s customer service department. Your dental plan should be able to provide you with clarification on any of its policies or payment protocols.