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Thursday, August 29, 2013

Dental Coverage by Class of Service

The amount of dental reimbursement a dentist receives usually depends on the type of service he or she has performed on the patient. This is known in dental plan terminology as “class of service,” which ranges from Class I to IV. The more extensive the dental treatment was, the less the coverage will be for the dentist. Class I pertains to diagnostic and preventive care. Regular checkups, cleanings, and dental x-rays are usually fully reimbursed.

Class II includes basic restoration; dental plans usually cover 80 percent of the cost of root canal and periodontal work. Class III involves advanced restoration procedures such as installing crowns and dental implants, and plans usually shoulder half of the cost. Finally, Class IV, which isn't a regular in dental plans, covers braces. The cost of orthodontic care is separate from a dentist's annual limit, but patients under 19 years of age may only be eligible for this type of reimbursement.

Keep in mind that most dental plans won't cover you for the whole year, as they usually set a number on the frequency of exams. They can only cover so many preventive care exams before dentists have to wait for next year for reimbursement. Dental plans also include time limits on certain services such as the replacement of prosthetics and orthodontics.

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