How Dental Insurance Really Works, and What You Should Know Before Renewing.
- Encompass Dental and Wellness
- Sep 29
- 3 min read
At Encompass Dental and Wellness, one of the most common questions we hear is:
“Will my insurance cover this?”
The reality? Often not in the way you’d expect.
Where traditional insurance falls short, our in-house membership plans are designed to fill the gaps, making sure your care doesn’t stop when your coverage does.
Dental insurance has remained largely unchanged since it was first introduced in 1954. Back then, the average annual maximum benefit was $1,000. Shockingly, that number hasn’t changed in nearly 70 years, even though the cost of dental services, materials, and insurance premiums has increased dramatically.
So what does this mean for you as a patient?
Let’s break it down.
Dental Insurance Today: More of a Discount Plan Than True Coverage
If you think of dental insurance the way you think of medical insurance, you’re likely to be frustrated. Today’s dental insurance functions more like a coupon book or discount program, rather than full coverage.
Here’s why:
Annual Maximums Are Still Low
Most dental plans still cap coverage at around $1,000–$1,500 per year, often not enough to cover even a single crown, root canal, or implant.
Deductibles Apply First
Just like with medical insurance, you’ll need to pay out-of-pocket until your deductible is met, typically $50–$150, before any benefits kick in.
Coverage Doesn’t Mean Full Payment
Many patients are surprised to learn that “coverage” doesn’t mean 100% covered. Insurance companies often base reimbursement on a “maximum allowable fee”, not the actual cost of your dentist’s care.
Limitations and Exclusions Are Common
Your plan may not cover certain procedures, materials, or newer technology. And often, there’s a waiting period or replacement limitation, meaning you may have to wait years before your plan will pay for a needed restoration.
Once You Hit the Cap, You’re On Your Own
If you need comprehensive care, it’s common to hit your yearly max early—and after that, you’ll pay out-of-pocket for any additional treatment, even cleanings.
A Patient-First Perspective from Encompass
At Encompass, we believe in being completely transparent about what your insurance will, and won’t, cover. We always encourage our patients to ask:
How much am I paying in premiums each year?
What’s my actual coverage benefit?
Does this plan really support my long-term dental health?
If your plan isn’t working in your favor, or if you don’t have insurance at all, we have better options.
A Smarter Alternative: Encompass Membership Plan
For patients without dental insurance—or for those tired of confusing policies and limited benefits, our in-house Membership Plan is a flexible, affordable alternative.
With the Encompass Membership Plan, you’ll enjoy:
Transparent, upfront pricing
No deductibles or yearly maximums
Routine preventive care included
Discounts on most additional treatments
No waiting periods, no claim denials
It’s dentistry without the red tape, just quality care when you need it.
We Also Offer Flexible Financing Options
Need treatment now but unsure how to budget for it? We’ve got you covered.
Encompass Dental and Wellness partners with multiple financing providers to help you access the care you need without sacrificing your health. Whether it’s payment plans, third-party financing, or phased treatment strategies, we’ll help you find a path forward.
Finally, Know Your Options. Plan with Confidence.
If you’re renewing your dental insurance, or considering going without, it’s worth taking a step back to evaluate what’s truly in your best interest.
At Encompass, our mission is simple:
To provide you with clear answers, honest guidance, and exceptional care.
📞 Have questions about your plan? Not sure if insurance or a membership is better for you?
Call our team today, we’re here to help.
At Encompass Dental and Wellness, we’re proud to be your trusted family dentist in Auburndale, FL, providing personalized, high-quality care for every stage of life. Our expert team, Dr. Thurston, Dr. Parker Duke, and Dr. Ashley Agnini, deliver a full spectrum of services, from preventive checkups to advanced cosmetic and implant dentistry. Whether you’re looking for a caring family dentist, an experienced cosmetic dentist in Auburndale, or expert dental implant solutions, we’re here to help you smile with confidence.
Explore more of our services, including preventive care, cosmetic dentistry, dental implants, wellness, and our affordable membership plan.
Located in the heart of Central Florida, Encompass Dental and Wellness combines cutting-edge care with a personalized touch, for healthier, happier smiles that last a lifetime.
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