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Dental Insurance

Dental insurance is a misnomer. It should be considered a benefit, rather than actual insurance. All dental benefits, whether in-network or out of network, have a yearly maximum and refer to a fee schedule when considering benefit coverage. The fee schedule they abide by rarely, if ever, coincides with the fees charged by a particular dental provider’s office.

Accepting other Insurance Plans as an out-of-network provider.

Dental insurance is a misnomer. It should be considered a benefit, rather than actual insurance. All dental benefits, whether in-network or out of network, have a yearly maximum and refer to a fee schedule when considering benefit coverage. The fee schedule they abide by rarely, if ever, coincides with the fees charged by a particular dental provider’s office.

In-network benefits refer to a contract between a dental provider and an insurance company. If your dentist enters into such a contract he/she must abide by the fees and treatment dictated by that insurance company. This does not mean the patient will not have a co-pay. When a patient opts to have treatment, other than regular cleanings, there is always a co-pay due at the time of service.

You, as a patient, and your dentist will determine the best course of treatment. However, deviating from your contracted fees and treatment could possibly mean an increase in your out of pocket expenses. Your dental benefits will NEVER cover all dental services at 100%.

With out-of-network benefits there is no contract between the dentist and the insurance company. This means you, the patient, are responsible for all charges not covered by your particular insurance plan and as with in-network benefits, you will always have a co-pay at the time of service. In most cases out-of-network benefits allow the provider to dictate standard and quality of care for their patients rather than the insurance company.

All dental plans have exclusions and possibly waiting periods for treatment. It is very important for you to be informed prior to making an appointment with your chosen provider regarding these waiting periods.

Generally all insurance (in/out of network) plans have a yearly deductible (individual and/or family) which must be met prior to any reimbursement for any treatment by your provider.

Dental benefits offered through your employer or purchased personally can be beneficial. It is the patient’s responsibility to know and understand their particular benefit coverage plan. Making educated decisions regarding your oral and overall health care is necessary for you to achieve the quality of care you deserve.

If you have any questions about your dental insurance or dental insurances we accept, please feel free to call us.