How Does Dental Insurance Work Pewaukee, WI
Many people are unaware of how dental insurance works. Fortunately, dental insurance plans are more straightforward and easier to understand than health insurance plans. Our team can help you learn about dental insurance plans, options, and how to make informed decisions about your oral health.
At Pewaukee Smiles Dentistry, we accept various dental insurances. If you are in Pewaukee and the surrounding area, call us today at (262) 264-6432 to schedule an appointment or learn more about our accepted dental insurance plans.
Shopping for Dental Insurance
When choosing dental insurance, many people want the insurance plan to include their current dentist. Most providers have websites with a directory of dentists within their network.
One can visit their dental insurance carrier's website to search for their dentist's in-network status. If their dentist is not within the network, patients can shop around for a different dental insurance provider. Alternatively, they can select a dentist in-network that accepts their insurance.
“When choosing dental insurance, many people want the insurance plan to include their current dentist.”
What to Look for in a Dental Insurance Plan
There are several options available for dental insurance, catering to a variety of needs. As such, types of coverage, deductibles, and premiums vary accordingly. To help narrow down their options, patients should first determine what plans are available in their area. Certain dental insurance companies only offer coverage to certain states, so begin by ruling out any impossibilities.
Next, patients should look for a plan that covers several dentists and dental practices – whether they have a preferred provider and practice or not. It is always best to have more options. Additionally, patients should consider all costs – including the monthly premium, deductible, and any co-pays they may have to pay. It is also important to note the annual maximum and what types of procedures are covered.
“To help narrow down their options, patients should first determine what plans are available in their area.”
Purchasing Dental Insurance
Purchasing dental is a personal issue and depends on how much dental work the patient needs and how many family members they have. Generally, the more dental work required and the more family members, the more value for the month.
The typical dental insurance plan covers preventive care: checkups and cleanings at 100% (no deductible), basic procedures (e.g., fillings and extractions) at 70%, and major procedures (e.g., crowns, bridges, and root canals) at 50%. Some procedures may be considered basic by one carrier and major by another, so patients must speak with their insurance carrier before getting dental treatments to understand the breakdown of costs and coverage.
Like health insurance plans, dental plans typically have a deductible — the amount one has to pay out of pocket each year before the plan starts to cover its portion of costs. Most plans cap the total amount they will pay for care per plan member per year. Any dental expenses over the plan's cap (or maximum) become the patient's responsibility.
“Purchasing dental is a personal issue and depends on how much dental work the patient needs and how many family members they have.”
Check out what others are saying about our dental services on Yelp: How Does Dental Insurance Work in Pewaukee, WI
Family & Individual Dental Insurance
Oral health coverage does not come as "one size fits all." Some may need insurance only for themselves, whereas others may be in the market for insurance for the entire family.
Patients can purchase individual dental insurance plans through the marketplace (U.S. government) when selecting their health insurance coverage or directly purchased through the carrier. Premiums for individual plans tend to be lower than family plans as only one individual is covered.
Family dental insurance plans cover the entire family and typically have higher premiums as more people seek coverage. Most family plans have allowances for two exams annually per plan member. Patients should find the right blend of insurance coverage that matches the entire family's oral care needs while still being affordable.
“Oral health coverage does not come as ‘one size fits all.’ Some may need insurance only for themselves, whereas others may be in the market for insurance for the entire family.”
Questions Answered on This Page
Q. How can I know if my dentist accepts my insurance?
Q. Is dental insurance worth it?
Q. What is the difference between family and individual dental insurance?
Q. What should I look for in a dental insurance plan?
Q. How can I find an affordable dental insurance plan for my family and me?
People Also Ask
Q. What factors should people consider when choosing a dental insurance plan?
Q. Who is the billing specialist?
Q. Why is preventative care important? How can it save you money?
Choosing Dental Insurance
Purchasing dental insurance can be an overwhelming experience. Luckily for many people, the plan offered by their employer or professional association is the best possible option. Still, in many cases, it may be useful for patients to talk to their dentists to see what plans they accept.
Many dental offices can recommend affordable plans that cover their patients' needs. Patients should look for a policy with a high spending cap if they know they will need major work done, while patients who require less work done can look for a policy with a lower spending cap.
“Many dental offices can recommend affordable plans that cover their patients’ needs.”
Frequently Asked Questions
Q. Can I be covered under multiple dental insurance plans?
A. You may, but one plan will probably be considered your primary plan. If this is the case, the primary plan will go toward your dental care first, with the other plan(s) covering the remaining costs. However, the plans cannot cover more than 100% of the treatment cost.
Q. What are the different kinds of dental plans?
A. Like health insurance plans, dental insurance plans are generally categorized either as Indemnity (e.g., HMO) or managed-care (e.g., PPO) plans. These plans mainly differ in the patient's choice of providers, how expenses are paid, and out-of-pocket costs.
Q. Why is dental health important?
A. Many people mistakenly believe that dental health is isolated from overall health. In reality, each system of the body is interrelated. In other words, neglecting your oral health could easily have disastrous effects on your overall health.
Q. Do I really need a dental insurance plan?
A. Yes. It can be costly to keep up with dental health, especially if you are making your routine checkups and cleanings as directed. Choosing the right dental insurance plan can help keep costs low while promoting proper healthcare.
Q. Whom should I talk to about any questions I have about my dental insurance plan's benefits or a claim?
A. It is best to directly contact your insurance carrier for any questions and concerns about your benefits or claims.
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Dental Terminology
Call Us Today
If you have questions about dental insurance options or whether or not a service is covered, call Pewaukee Smiles Dentistry in Pewaukee at 262-264-6432 to learn more.
Helpful Related Links
- American Dental Association (ADA). Glossary of Dental Clinical Terms. 2025
- American Academy of Cosmetic Dentistry® (AACD). Home Page. 2025
- WebMD. WebMD’s Oral Care Guide. 2025
About our business and website security
- Pewaukee Smiles Dentistry was established in 2025.
- We accept the following payment methods: American Express, Cash, Check, Discover, MasterCard, and Visa
- We serve patients from the following counties: Waukesha County
- We serve patients from the following cities: Pewaukee, Village of Pewaukee, Hartland, Merton, and Sussex
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