Dental EOB at Family First Dental

Many patients struggle to understand dental insurance. Words such as deductible, coinsurance, and annual limits can be confusing. In this article, we explain how your dental EOB and breakdown of benefits work following treatment at Premier Dental Clinic.
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.
How Dental Insurance Works for City Patients

Dental insurance is designed to reduce out-of-pocket costs while encouraging preventive care. Many plans follow a standard coverage structure:

Preventive care is commonly paid at 100% by dental plans.

Basic dental work often receives partial coverage of around 70–80%.

Crowns and other major treatments usually receive the lowest coverage level.

Many plans follow a 100–80–50 coverage model.

See common procedures we perform to better understand your care options.
Common Dental Insurance Terms Explained

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 amount used by your plan to calculate benefits.

Annual Maximum: The yearly cap on insurance benefits.

Non-Covered Services: Procedures not covered under your plan.
Example: How Benefits Apply to Procedure_Type

The following example is for illustration only. Your real costs depend on your policy details.
| 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 EOB will show similar information.
Understanding Your Dental EOB

The dental office submits billing to your insurer.

Your insurance processes the claim and sends you an EOB.

It lists what was covered and what you may owe.

The EOB does not require payment.
Dental Insurance Questions Patients Ask

Why is there a difference between the dentist’s charge and here the allowed amount?
Plans calculate benefits using negotiated rates.

Does preventive care really cost nothing?
Preventive visits usually require no payment when in network.

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.

Options When Dental Bills Are Higher

Unexpected balances sometimes occur. We encourage patients to contact us before treatment when possible.

Request a pre-treatment estimate for major procedures.

Ask about payment plans or financing options.

Plan treatments around your benefit year when appropriate.

Trusted Dental Care in City

Years of experience helping patients understand benefits.

Convenient location and flexible hours in City.

Acceptance of many major dental insurance plans.

See our patient reviews to learn more.