What Dental Insurance Really Covers (And What It Doesn’t)

You thought your dental plan had you covered—until the bill came.

Maybe it was a crown. Maybe a root canal. Maybe just a routine cleaning that wasn’t so routine after all.

And suddenly, you’re staring at a statement with more out-of-pocket costs than you expected. Why wasn’t this covered?

At Mere, we help clients avoid surprise bills by explaining the fine print most people don’t see until it’s too late.

Dental insurance is not designed like health insurance.

It has annual limits, waiting periods, and tiers of coverage that can make a big difference in what’s actually paid for—and when.

We believe you deserve to know how your plan really works, so you can make smart decisions for yourself and your family.

What Most Dental Plans Cover:

Preventive Services (usually covered at 100%)

• Routine cleanings (typically 2 per year)

• Exams and x-rays

• Fluoride treatments (often for children only)
  Tip: These are the most “budget-friendly” part of any dental plan. Use them!

Basic Services (covered around 50%–80%)

• Fillings

• Simple extractions

• Some emergency visits

• Periodontal maintenance (not deep cleaning)

Major Services (often subject to waiting periods and low coverage)

• Crowns, bridges, and dentures

• Deep cleanings (scaling and root planing)

• Implants

• Oral surgery

Most plans have a 6–12 month waiting period before major work is covered—and even then, you may still pay 50% or more of the cost.

Other Fine Print to Watch For:

• Annual maximums (usually $1,000–$2,000 per year)

• Missing tooth clauses on replacement work

• Out-of-network restrictions (especially with discount plans)

• Cosmetic services like teeth whitening or veneers? Not covered in most plans

Here’s the Plan:

1. Schedule a quick consult with our team

2. We’ll explain your current plan—or help you choose a better one

3. You’ll know what to expect before you schedule your next visit

4. Make empowered decisions—not expensive surprises

You deserve clarity—not confusion—when it comes to your dental care.

Whether you’re reviewing an employer plan, shopping privately, or figuring out what’s best for your child or spouse, our team can help.

Call or text (904) 654-5450 or visit www.merebenefits.com to get started today.

Frequently Asked Questions

Why does dental insurance seem so limited compared to medical?

Dental insurance is designed for routine care and some coverage of more expensive services. It’s meant to reduce the cost—not eliminate it. We’ll help you set realistic expectations based on your plan.

What’s the difference between dental insurance and discount dental plans?

Discount plans offer reduced rates at participating providers but are not true insurance and don’t cover procedures. We’ll explain which is right for your situation.

Do you offer plans for seniors or Medicare recipients?

Yes! We offer standalone dental plans or bundled packages that complement Medicare coverage. We’ll help you compare options and find the best fit.