Having Dental insurance or a dental benefit plan can make it easier to get the dental care you need. But most dental benefit plans do not cover all dental procedures. Your dental coverage is not based on what your dentist recommends. It is based on how much your employer pays into the plan. When deciding on treatment, dental benefits should not be the only thing you consider. Your treatment should be determined by you and your dentist.
Many plans tell their participants that they will be covered "up to 100%" but do not clearly specify plan schedule allowance, annual maximum, or limitations. It is more realistic to expect dental insurance to cover 35%-65% of major services up to the annual maximum. Remember, the amount a plan pays is determined by how much the employer paid for the plan. You get back only what your employer put in. The less your employer paid for the plan, the less you get back.
Various major dental services are NOT covered by insurance companies. Oftentimes insurance companies will apply an "alternate" benefit towards a service. As a courtesy, our office can file a pre-determination to your insurance company for major services, to provide you with the amount that is going to be covered. Some dental plans exclude coverage for certain treatments, such as cosmetic and implant services, or have age limitations, such as for fluoride treatment. Like medical insurance, most dental plans do not offer coverage for pre-existing conditions, such as missing teeth.
Cosmetic, restorative and family dentistry
Payment is expected at the time of each visit; please note that our office is NOT a preferred provider for ANY insurance company. Please bring your insurance card to your first visit with us; we may make a copy for your chart. Our office is OUT of network, if you are covered by a PPO policy, as a courtesy we will file the claim up to two times on your behalf with your dental insurance. However if no payment is received from your insurance, within 60 days, you will be responsible for the full payment amount for the date of service.
At the time of service, we will expect payment of your portion, to include but not limited to: your annual deductible, co-insurance, co-payment, non-covered services, pre-existing (missing tooth clause) and disputed claims over 60 days.
Please read and understand your insurance benefits BEFORE your appointment and keep your explanation of benefits statement from your insurance company. We are not responsible for knowing YOUR POLICY or the coverage.
If you would like to finance your dental expenses we work with CareCredit, at 0% interest for one year and will be glad to provide you with the information and how to apply. Get pre-approved today at www.carecredit.com.