Dental Insurance Facts

Filing insurance claims We will help you in every way we can in filing your claims and handling your insurance questions.

Dental insurance is not meant to be a pay all. It's only meant to be an aid. You are very fortunate if you have dental insurance coverage and don't have to pay the entire fee out of your own pocket. Many of our patients don't have any dental insurance at all.

Some of our patients have excellent dental insurance policies, some have fair policies, and some have poor policies. Many plans tell you you'll be covered up to 80% - 100%. In spite of what you're told, we've found that most plans cover only 15%-70% of the average fee. We realize that every bit of assistance you get from your insurance company is a big help, and we are glad you have coverage. However, it must be understood that how much your policy covers has already been determined by how much your employer paid for your insurance policy. The less your employer paid for the insurance, the less you'll receive.

FOR EXAMPLE:

PLAN A                    PLAN B
Costs a lot of money      Costs one-half the amount
Deductible is $25.00      Deductible is $50.00
Pays $42.00 on a filling  Pays $17.50 on a filling
Yearly maximum is 1,000   Yearly maximum is $500

It has been the experience of many dentists that some insurance companies tell their customers that "fees are above the usual and customary" rather than saying, "our benefits are low." Your insurance company sets the "allowables" or "usual and customary fees" depending on how much your employer paid for your policy. It's just like your car insurance. The lower the benefits you choose, the less it costs you in premiums.

Many necessary routine dental services are not covered by dental insurance at all. Again, what is covered and what is not is determined by what benefits your employer purchased for you.

Our fees are based on the experience we have in performing each procedure and the quality of the laboratory and materials we use. We do not believe it is in your best interest for us to compromise your treatment in order to accommodate an insurance policy's restrictions that may provide you with a quality of care that is considerably less than you deserve. However, we are more than happy to discuss a treatment plan's advantages and disadvantages with you, alternative treatment plans if possible, and help you choose the type of treatment that you feel is best for you.

The type of treatment we recommend is based upon professional judgement, not on whether you are covered by a dental benefit plan. We strongly feel that you, not your insurance company, should choose the treatment you feel is best for you.