Dental insurance often feels confusing for patients. Words such as deductible, coinsurance, and annual limits can be confusing. This page walks you through how dental billing and EOBs work at CityCare Dental.
Whether you are new to our office or reviewing a recent statement, this guide can help. You can also visit our Financial Options page for one-on-one support.
Dental Insurance Basics for City Residents
Dental insurance is designed to reduce out-of-pocket costs while encouraging preventive care. Coverage is often divided into categories based on treatment type:
Preventive care is commonly paid at 100% by dental plans.
Fillings and basic procedures are typically covered at a moderate percentage.
Major dental services tend to be covered at approximately 50%.
A common structure is 100–80–50 for preventive, basic, and major care.
See common procedures we perform to better understand your care options.
Key Terms on Your Dental Breakdown of Benefits
Deductible: An initial out-of-pocket amount required by your plan.
Copay / Coinsurance: Your share of costs once insurance applies.
Allowed Amount / Negotiated Fee: The maximum fee your insurance recognizes for a service.
Annual Maximum: The maximum benefit available in a benefit year.
Non-Covered Services: Treatments excluded by your policy.
Example: How Benefits Apply to Procedure_Type
These numbers are examples and not exact quotes. Final amounts vary by insurance plan.
| Item | Example Amount |
| ------------------------------ | -------------------------- |
| Dentist’s standard fee | Base_Fee |
| Plan’s allowed amount | Allowed_Fee |
| Deductible applied | Deductible_Amount |
| Plan payment (Coverage_%%) | Plan_Payment |
| Patient responsibility | Patient_Responsibility |
Your insurance statement will reflect these line items.
How to Read Your Dental Explanation of Benefits
The dental office submits billing to your insurer.
Your insurance processes the claim and sends you an EOB.
The document outlines insurance and patient responsibilities.
An EOB is not a bill.
FAQs About Dental Billing at Family First Dental
Why is there a difference between the dentist’s charge and the allowed amount?
Insurance plans set contracted fee limits.
Does preventive care really cost nothing?
Routine care is often fully covered.
What happens when I reach my annual maximum?
Insurance stops paying once the maximum is reached.
Why are some services not covered?
Plans may exclude or limit certain treatments.
Who should I contact if I disagree with my EOB?
Our office can help review your claim.
What to Do if Costs Are Higher Than read more Expected
Out-of-pocket expenses can increase depending on plan rules. Planning ahead can reduce unexpected costs.
Obtain benefit estimates when available.
Ask about payment plans or financing options.
Timing care may help maximize benefits.
Trusted Dental Care in City
Commitment to clear communication and preventive care.
Easy access for local patients.
Acceptance of many major dental insurance plans.
See our patient reviews to learn more.