How Dental Insurance Works
Dental insurance is designed to encourage preventive care while helping offset the cost of restorative treatments when needed. While every plan is different, most PPO dental insurance policies follow a general structure:
- Preventive care (cleanings, exams, X-rays) is often covered at or near 100%
- Minor restorative services are typically covered up to 80%
- Major services may be covered up to 50%
- Orthodontic treatment is covered on select premium plans, often up to 50%
- Cosmetic services are generally not covered
Your plan may also include an annual maximum, a deductible, and waiting periods for certain procedures. Our team can help you understand how these factors apply to your specific coverage.
Dental Insurance vs. Medical Insurance
Dental and medical insurance serve different purposes. Medical insurance focuses on systemic health and major illnesses, while dental insurance emphasizes preventive and routine oral healthcare, such as exams, cleanings, and fillings. In some cases, there may be overlap—such as coverage for certain oral surgeries—but in most situations, dental insurance is your primary resource for routine dental care.
In-Network & Out-of-Network Coverage
Whether Martinez Dentistry is in your insurance network or not, we’ll help you maximize your benefits and minimize stress.
In-Network Providers
Being in-network allows us to offer controlled pricing and often results in lower out-of-pocket costs for patients. Martinez Dentistry is proud to be in-network with Delta Dental Premier.
Out-of-Network Benefits
If you have a PPO dental insurance plan, you can typically use it at nearly any dental office. Even if we’re not in-network with your provider, you’re still welcome to use your benefits at our practice. Our team will gladly file claims on your behalf and explain how your coverage works so you can focus on what matters most—your oral health.
Need Help Understanding Your Benefits?
Many patients never reach their annual insurance maximum simply because they’re unsure how their benefits work. We don’t want you to miss out on valuable savings. If you have questions about your policy, coverage details, or ways to make treatment more affordable, just give us a call. We’re here to help you make the most of your dental insurance at both of our locations.
Contact Martinez Dentistry today to learn more or schedule your next appointment.