Understanding dental insurance can feel overwhelming. Terms like deductibles, copays, annual maximums, and coverage percentages are hard to follow. This guide explains how your dental billing breakdown of benefits and dental Explanation of Benefits (EOB) work after your visit at Family First Dental.
Whether you are new to our office or reviewing a recent statement, this guide can help. You can also visit our Financial Options page for one-on-one support.
How Dental Coverage Works in City
Most dental plans aim to lower patient costs and emphasize preventive treatment. Many plans follow a standard coverage structure:
Preventive services like exams and cleanings are often covered at 100%.
Fillings and basic procedures are typically covered at a moderate percentage.
Crowns and other major treatments usually receive the lowest coverage level.
Many plans follow a 100–80–50 coverage model.
Explore our dental treatments to better understand your care options.
Common Dental Insurance Terms Explained
Deductible: The amount you pay before insurance starts sharing costs.
Copay / Coinsurance: Your share of costs once insurance applies.
Allowed Amount / Negotiated Fee: The maximum fee your insurance recognizes for a service.
Annual Maximum: The maximum benefit available in a benefit year.
Non-Covered Services: Services your plan does not pay for.
Dental Insurance Example for Procedure_Type
These numbers are examples and not exact quotes. Actual coverage depends on your specific dental plan and remaining benefits.
| Item | Example Amount |
| ------------------------------ | -------------------------- |
| Dentist’s standard fee | Base_Fee |
| Plan’s allowed amount | Allowed_Fee |
| Deductible applied | Deductible_Amount |
| Plan payment (Coverage_%%) | Plan_Payment |
| Patient responsibility | Patient_Responsibility |
Your insurance statement will reflect these line items.
How to Read Your Dental Explanation of Benefits
The dental office submits billing to your insurer.
Your insurance processes the claim and sends click here you an EOB.
It lists what was covered and what you may owe.
The EOB does not require payment.
Dental Insurance Questions Patients Ask
Why is there a difference between the dentist’s charge and the allowed amount?
Plans calculate benefits using negotiated rates.
Does preventive care really cost nothing?
Preventive visits usually require no payment when in network.
What happens when I reach my annual maximum?
You may be responsible for full costs afterward.
Why are some services not covered?
Some procedures are not included under specific policies.
Who should I contact if I disagree with my EOB?
Our office can help review your claim.
Managing Unexpected Dental Costs
Dental costs can be higher due to deductibles, annual limits, or non-covered services. Speaking with our office in advance can help avoid surprises.
Ask for insurance estimates before larger treatments.
Discuss flexible payment solutions.
Strategic scheduling can reduce costs.
Why Patients Choose Our Dental Office
Experienced dental team focused on patient education.
Serving City and surrounding areas.
Experienced in handling dental insurance claims.
Visit our Google reviews to learn more.