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Insurance
When it comes to your dental insurance, understanding what qualifies as “major care” can help you plan ahead and feel more confident about your treatment.
At Thrive Dental & Orthodontics, we help patients across Dallas, North Dallas, Frisco, Allen, Richardson, and Sachse navigate their insurance every day. Whether you’ve been recommended a more advanced procedure or simply want to understand your benefits better, we’re here to guide you every step of the way.
Accepted Carriers
18+ Plans
Metlife
Guardian
Principal Life
Cigna
Humana
Beam
United Healthcare
Assurant
United Concordia
Delta Dental
Ameritas
Dentaquest
Aetna Dental
Lincoln Financial
MCNA
Blue Cross Blue Shield
UMR
TMHP
- We accept ALL PPO Dental Insurance plans
What Is Considered Major Care in Dental Insurance?
Major care typically includes more complex procedures that restore the function, strength, and long-term health of your smile. These treatments often require more planning and may involve multiple visits.
Most dental insurance providers consider the following services as major care:
- Dental crowns to protect and strengthen damaged teeth
- Bridges or dentures to replace missing teeth
- Root canals to treat infection inside the tooth
- Surgical dental extractions
- Advanced restorative procedures
These treatments play an important role in preserving your smile and preventing further complications.
How Dental Insurance Covers Major Care
Dental insurance is designed to support your care throughout the year, but major procedures are typically covered at a lower percentage than preventive or minor services.
In most plans:
– Preventive care is covered at the highest level
– Minor care receives moderate coverage
– Major care is usually covered at 50–70% after your deductible
– An annual maximum limits how much your insurance will pay
Because major treatments often have higher costs, it’s important to understand how your benefits apply before starting care.
Once your deductible is met, your insurance begins contributing toward these procedures. Planning ahead can help you maximize your benefits and reduce out-of-pocket expenses.
How Major Insurance Providers Handle Major Care
While every dental insurance plan is different, most major providers follow a similar structure when it comes to major care.
Here’s what you can typically expect:
– Coverage is often around 50–70% depending on your plan
– A deductible must usually be met first
– Annual maximums may limit how much is covered in a year
– Some procedures may require pre-authorization
Because of these variations, it’s always a good idea to confirm your specific coverage before moving forward with treatment.
How to File a Dental Insurance Claim
Filing a dental insurance claim for major care may sound complicated, but we help simplify the process for you.
In most cases:
– Our team submits your claim directly to your insurance provider
– We include all necessary documentation for approval
– Your insurance reviews and processes the claim
– Payment is applied based on your plan’s coverage
If your plan sends reimbursement directly to you, we’ll walk you through the process so everything stays clear and manageable.
Need Help Financing? You’ve Got Options
Even with insurance, major care can come with some out-of-pocket costs. The good news is that you have flexible options to make your treatment more accessible.
One of the best alternatives is our Dental Discount Plan, which offers:
– Transparent, predictable pricing
– Savings on preventive, minor, and major treatments
– No annual maximums limiting your care
– No waiting periods
Many patients choose this option because it provides more flexibility and eliminates many of the restrictions that come with traditional insurance.
Why Patients Choose Thrive for Major Care Guidance
We understand that major dental treatment can feel like a big decision. That’s why we focus on making the process as clear and comfortable as possible.
When you visit Thrive, you can expect:
- Clear explanations of your treatment and options
- Help understanding your insurance coverage
- Transparent cost estimates before treatment
- A supportive, patient-first approach t
We’re here to help you feel confident in your care and your decisions.
Let’s Plan Your Care with Confidence
Major dental care is an investment in your long-term health, comfort, and confidence. With the right guidance, it becomes much easier to navigate your options and take the next step.
If you have questions about your coverage or want to explore your treatment options, we’re here to help.
Contact us today to schedule your visit or learn more about your benefits.
Frequently Asked Questions About Dental Insurance
Navigating dental insurance can be confusing. We’re here to make it simple. Below you’ll find answers to common questions about coverage, claims, and how our team helps you get the most out of your benefits.
What is considered major care in dental insurance?
Major care includes more advanced procedures such as crowns, bridges, dentures, root canals, and surgical extractions. These treatments focus on restoring the function and structure of your teeth.
How much does insurance cover for major care?
Most dental insurance plans cover around 50–70% of major care services after your deductible has been met. Coverage can vary depending on your specific plan.
Do I need approval before starting major treatment?
Some insurance providers require pre-authorization for major procedures. Our team can help you check your coverage and submit any necessary documentation.
What if I reach my annual maximum?
If you reach your annual maximum, your insurance will stop contributing for the rest of the year. We can help you plan your treatment in phases to maximize your benefits.
Can I use the Dental Discount Plan instead of insurance?
Yes, the Dental Discount Plan is a great alternative that offers predictable pricing and savings without many of the limitations of traditional insurance.
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