What May be Covered By a Dental Deductible?

At Medplex Pediatric Dentistry, we encourage you to use your benefits before the end of the year because many times, if you don’t use your dental benefits, you can lose them.

It’s important to understand that carriers often categorize procedures into three categories – preventive, basic, and major. If you haven’t reached your yearly deductible, some if not all of these procedures will count towards your deductible:


  1. Cleanings
  2. X-Rays
  3. Sealants

The preventive benefits on dental plans are usually a great way to keep from incurring costs later.


  1. Fillings
  2. Extractions

Usually, with this category of procedures, the benefits are close to 100% covered and in the range of 70-80% total cost. Many times, you can minimize the need for basic procedures if you are diligent with preventive care. However, sometimes accidents occur, or teeth come in that need to be removed based on their position or effect on another tooth.


  1. Crowns
  2. Braces

Major dental procedures can be grouped and paid for in a variety of ways depending on your dental plan. Speak with Medplex and your carrier to best understand how these types of procedures are handled on your plan because coverage varies.

Other important things to know:

  • Most dental insurance policies do not cover any costs for cosmetic procedures such as teeth whitening, tooth shaping, veneers and gum contouring.
  • While most medical insurance policies have yearly out-of-pocket maximums, the majority of dental policies cap the amount of annual coverage.
  • Any leftover tax credit not used to pay for your family’s health insurance purchased through Healthcare.gov may be applied to pediatric dental insurance premiums if your medical insurance policy does not include dental coverage. If your health insurance policy includes children’s dental coverage, you cannot use tax credits to buy an additional plan.

Adapted from https://www.investopedia.com/articles/personal-finance/111715/how-does-dental-insurance-work.asp on 11/28/18


Medplex Pediatric Dentistry serves as a top rated pediatric dentist for Alabaster, Birmingham, Hoover, Helena, and Pelham, AL