Navigate Dental Insurance
Navigating dental insurance in Topsham ME and Biddeford ME can feel like learning a foreign language. Copays, deductibles, exclusions... It’s a lot. At Gentle Dental, our mission is to take that stress off your plate. Whether you're here for a simple cleaning or something more involved, we’re here to help you understand your coverage, avoid surprises, and make the most of your benefits.
We Dental Insurance Plans
We believe that high-quality dental care should be accessible. That’s why we work with a broad network of insurance providers to help make your care more affordable. Our team handles claims from start to finish, so you don’t have to lift a finger when it comes to paperwork.
Just a few of the plans we accept include:
Not seeing your plan listed? Give us a call—we’ll gladly check your coverage and walk you through your options.
How We Help You Navigate Dental Insurance
Understanding the fine print of your plan shouldn't be your job. That’s where we come in. Here’s how we simplify the process for you from the moment you schedule your visit:
- Insurance Verification
Before your appointment, our front desk team verifies your coverage so we can give you a clear picture of what your plan includes—and what it doesn’t. - Treatment Planning
We'll help you understand how your insurance applies to your recommended treatment. If there are choices to be made, we’ll outline your options, break down costs, and guide you through what’s covered. - Claim Submission
Once your treatment is complete, we submit your claim directly to your provider. No forms, no hassle—you just focus on your recovery. - Payment Support
After insurance has processed your claim, we’ll walk you through any remaining balance. We also offer flexible payment options for out-of-pocket expenses, so you’re never caught off guard.
PPO vs. HMO Dental Plans: What’s The Difference?
If you're trying to understand your plan—or choose a new one—it helps to know the basics of the two most common types: PPO and HMO.
PPO (Preferred Provider Organization) Plans
PPO plans are the most flexible and widely used. They allow you to see both in-network and out-of-network dentists, though you’ll get the best rates with a participating provider.
Typical PPO coverage includes:
- 100% for preventive care (cleanings, exams, X-rays)
- 70–80% for basic procedures (fillings, extractions)
- 50% for major services (crowns, bridges, root canals)
Most PPO plans have an annual maximum benefit between $1,000 and $2,000.
HMO (Health Maintenance Organization) Plans
HMO plans typically offer lower premiums but limit you to a specific network. You’ll need to choose a primary dental provider and receive referrals for any specialist care.
HMO highlights:
- Lower monthly costs and set copays
- Must stay in-network for all services
- Often requires prior authorization for more complex treatments
Not sure which type you have? We’ll explain your plan and help you make the most of it.
Dental Insurance FAQs: Your Questions Answered
What’s a covered benefit?
It’s any treatment your plan agrees to pay for, either fully or partially—like cleanings, fillings, or crowns. Each plan has its own list of covered procedures.What is an optional treatment?
Optional treatments are services that your insurance may not cover—often cosmetic procedures like whitening or veneers. If something falls outside your coverage, we’ll let you know upfront.Can I use my benefits for cosmetic dentistry?
Most dental insurance plans don’t cover elective cosmetic work. However, if a cosmetic procedure is tied to restoring function (like a crown), some coverage may apply.Will I have to pay anything out of pocket?
Depending on your coverage, you may have deductibles, copays, or uncovered services. We’ll estimate your costs before treatment begins and offer solutions if you need help covering a balance.
Let’s Take The Confusion Out Of Dental Coverage
You shouldn’t have to be an insurance expert to get the care you need. At Gentle Dental, our team is here to support you at every step—from explaining your benefits to making sure you’re getting the most value from your plan.
Ready to schedule an appointment or need help reviewing your coverage? Give us a call today. We’ll handle the insurance. You just focus on your smile.
