Dental Benefits Terminology: Deductible
If your dental plan has a deductible, it's important to understand what it means. A deductible is the amount you pay out-of-pocket before your plan's dental benefits are calculated. Deductibles are applied per your plan's contract period, not per visit. Once you've met the deductible, you won't have to pay it again during the remainder of the contract period.
Your dental plan may have individual and family deductibles. Individual deductibles are applicable to each enrolled family member until the amount of the family deductible is met. For example, if your plan has an individual deductible of $50 and a family deductible of $100, the family deductible will be considered met once the combined amounts paid by any enrolled family members toward individual deductibles reaches a total of $100. After the family deductible has been satisfied, no further deductible payments will be required by any enrolled family member during the contract period, even if they have not met the individual deductible.
If your plan includes a deductible, the individual and family amounts (if applicable) and the service categories they apply to should be specified on the schedule of benefits. Deductibles usually don't apply to preventive services like cleanings or to orthodontic services. However, since not all dental plans are the same, reference your plan's documentation to review the terms of any deductible that may be applied.
Understanding the deductible can help you make the most of your dental benefits. For additional guidance with this and other dental terminology, contact your dental plan administrator or your SDC representative.