Dental Benefit Basics: Common Terms Defined

November 20, 2014

If dental benefit terms confuse you, you’re in good company. A 2013 survey found that 51 percent of U.S. adults were unable to accurately identify common health insurance terms. In order to better understand dental benefits, it’s important to start with the basics. That’s why we’re breaking down 4 commonly confused dental definitions - plain and simple.

1. Coinsurance

Coinsurance is the percentage you pay for a dental procedure. Delta Dental pays a percentage and you pay a percentage. For example, if you have a filling and your coinsurance is 20% for fillings. Delta Dental pays 80% and you pay 20% of the cost for your filling.

2. Co-pay

A co-pay is a cost-of-sharing arrangement in which you pay a specific charge at the time of service. For example, $15 for a routine dental check-up.

3. Deductible

A deductible is a specific dollar amount you pay before the dental provider pays their portion. Deductibles usually apply to basic or major treatment, not cleanings and exams.

4. Premium

Typically a monthly charge, a premium is the total amount paid to the dental provider for your coverage. Your employer pays the premium in whole or in part.

What other questions do you have about dental benefits? Are there additional terms you’re confused about? Let us know in the comments section!