Periodontics

Periodontics is the area of dentistry concerned with the prevention, diagnosis, and treatment of gum disease and supporting bone structures around the teeth. Treatments may include deep cleaning (scaling and root planning), gum grafts, and maintenance therapy.

Dental plans classify periodontics as either basic or major restorative depending on the insurer. Reimbursement rates typically range from 50 to 80 percent, and waiting periods may apply for more extensive procedures.

Example:

If your plan covers 80 percent for basic dental and your periodontal cleaning costs $250, the insurer pays $200 and you pay $50.

What to Watch For:

Confirm how your plan classifies periodontics, since major restorative procedures may have lower reimbursement rates and waiting periods.

Related Terms

Paramedical Disciplines

Paramedical disciplines refer to regulated health professionals who provide therapy or rehabilitation services outside of hospital settings. Common examples include physiotherapists, chiropractors, massage therapists, acupuncturists, naturopaths, osteopaths, psychologists, and speech-language pathologists.

Pay-Direct card / Drug card

A pay-direct card, also known as a drug card, is a plastic or digital card issued by your health insurance provider that allows pharmacies to bill your insurer directly for eligible prescription drugs. Instead of paying the full cost upfront and submitting a claim later, you pay only your portion - such as a deductible or coinsurance - at the point of sale.

Per Incident

Per incident refers to the way certain insurance benefits are calculated or limited based on each separate event, illness, or accident rather than by year or lifetime. When a benefit is paid “per incident,” it means you are eligible for reimbursement each time a new, distinct occurrence happens, up to the maximum amount specified for that type of claim.

Per Person / Per Family

Per person and per family describe how benefit limits, deductibles, or maximums are applied within a health or dental insurance plan. A per person limit means the specified amount applies individually to each insured member, while a per family limit represents the total combined coverage for all members under one policy.

Per-Practitioner Annual Maximum (Paramedical)

The per-practitioner annual maximum is the total amount your plan will reimburse for services from one specific type of provider in a single benefit year. For example, if your plan pays up to $500 for massage therapy annually, once that amount is reached, additional treatments from that provider type are no longer covered until the next year.

Have questions about your insurance coverage?

Our licensed advisors can help you understand your options and find the right plan for your needs.