Dental insurance is a highly complex subject that creates confusion for many dental patients. The lack of sufficient information being provided causes many to not use their insurance to it's full potential. We will work directly with your insurance company to save your hard earned money!
Covered & Non- Covered Services
Some of the services you may need or want will not be covered by your dental insurer. Our goal is to help you achieve and maintain optimal dental health, which is not necessarily the goal of your insurance company. We do not want to compromise your care or your confidence based on the restraints placed by your insurance.
Some services are typically not covered by dental insurance companies. These may include: cosmetic dentistry, implants, occlusion or bite redesign, whitening, and other services. Although these are important dental services that can greatly enhance the quality of life of our patients, dental insurance companies do not feel that they should have to pay for these services. That is way these services are rarely included in your contract.
What is Dental Insurance?
Dental insurance is a contract between your employer and a dental insurance company. The benefits you will receive are based on the terms of the contract your employer negotiated with the dental insurance company and NOT the dental office. The services selected by your employer are based on the cost of the policy to the employer and the negotiated agreements with the dental insurance company.
Because the benefits you have are decided between your employer and the dental insurance company, some services may not be covered. The non-covered services are not based on what you need or want, but strictly on the contract with the insurance company. This is why many dental insurance companies rarely cover 100% of any dental fee. In many cases, they cover less than 50% or nothing at all. We suggest you read your plan booklet to familiarize yourself with any services not covered in your plan benefits.
Maximums, Deductibles, & Waiting Periods
Most patients do not realize that each dental insurance plan has a dollar amount limitation each year. Once this limit is reached, no other services will be covered by your dental insurance company regardless of how essential the service may be to your dental health.
Dental insurance companies also have a yearly deductible amount. This amount is taken out of the insurance payment and is paid by the patient.
Some plans have a combined deductible with medical insurance. Occasionally , dental benefits will not be paid until the medical deductible has been met.
Many insurance companies also apply a waiting period for certain services and will not pay for another service until the waiting period is over. In these circumstances no payment by insurance will be made.