Dental Insurance

Important Facts Regarding Dental Insurance

Dental insurance is rapidly playing a more prominent role in helping patients obtain the dental care they need. Our patients deserve the best possible dental care we can provide. In an effort to maintain this high quality care, we would like to share with you some facts about dental insurance and how it works.

FACT #1

Dental insurance is meant to be an aid to help restore your mouth to sound dental health.

The amount your plan pays is determined by the quality of the plan purchased by your employer. The less paid for the insurance plan, the less benefit you will receive. We have found that many plans cover 40% to 70% of an average treatment plan fee. For the same procedure, some plans pay more – some less.

FACT #2

Occasionally, insurance companies tell their clients that certain dental fees are “above the usual and customary” or UCR, rather than tell them that the insurance benefits are too low. We know that some insurance companies do not upgrade fee schedules, even with the cost of living index. Their schedule of benefits often lags current dental fees by 12-18 months.

Dental insurance in the 1970’s paid out an average of $1,000 of dental benefits per year. Today, more than 30 years later, the average is still only $1,200. Although helpful, this unrealistic yearly maximum benefit will rarely cover a significant portion of extensive or advanced cosmetic dental treatment plans. For larger cases, we offer financial options so your dental needs can be adequately met.

FACT #3

Many routine and recommended dental services are not covered by insurance carriers. In fact, even some preventive procedures are not covered at all. There are a number of clauses insurance companies use to deny payment, such as advanced cosmetic services, pre-existing conditions, and alternate (cheaper) procedures. Please read your policy carefully to become aware of its limitations.

FACT #4

We are here to help you sort through the confusing issues related to your dental insurance and would be happy to discuss our fees and policies with you at any time. As a courtesy, we will gladly submit your insurance claim after each visit. The patient, however, is responsible for the total fee and will be expected to make up for any deficiencies in the insurance coverage.

FACT #5

Our Commitment to You – We will plan our treatment to provide you with the finest care available and help you obtain the maximum reimbursement from your dental insurance carrier, while remaining sensitive to your particular financial circumstances.

Your Commitment to Us – You are responsible for payment of all dental fees, co-pays and deductibles at the completion of each appointment. This will greatly streamline our bookkeeping and help us to keep our fees competitive. We accept cash, checks, Visa, MC, and Discover. We also offer financing options for patients who qualify.