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 dental fee plan out of your own pocket. Many patients don't have any dental insurance at all. Some 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, most plans cover only 15% - 70% of the average dental fee plan. We realize that every bit of help 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 he/she paid for the insurance, the less you'll receive.
Your insurance company sets the "allowables" or "a usual and customary dental fee plan" 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. What is covered and what is not is determined by what benefits and dental fee plan your employer purchased for you.
We will make every effort to get the most value from your insurance coverage. However, we do not believe it is in your best interest for your treatment to be compromised 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. At Today’s Dental, we strongly feel that you, not your insurance company, should choose the treatment you feel is best for you and your family. We will present any options that will provide you with quality dental care.
MYTHS AND FACTS ABOUT DENTAL BENEFITS
Myth: Dental insurance is similar to medical insurance.
Fact: Dental benefits can help pay for limited services such as preventative care and some single tooth or single quadrant dentistry within a calendar year, but dental benefits are limited they pay for a very small percentage of the fees for multiple tooth dentistry and complex treatment plans. Some dental procedures are not covered at all by dental benefits.
Myth: I should ask the doctor to limit treatment to those items covered by my dental benefits.
Fact: We have an ethical obligation to diagnose and share our findings with you. We base our treatment recommendations on the needs of our patient, not the limitations of the benefits. We respect your right to make decisions regarding your oral health, but we want you to be totally informed.
Myth: If the doctor is not on my plan I will not receive any benefits.
Fact: It all depends on the plan. Even if we do not work directly with your particular plan we will submit the claim for you. We ask that you pay us at the time of service and, it is possible - although not guaranteed - that you will receive some reimbursement back from the insurance company,
Myth: Insurance companies are a good source of information regarding dental fees.
Fact: Insurance companies base their "usual and customary" fees on averages. The companies have no incentive to keep these statistics up to date (because it would cost them money), and our practice is not average. The fees here reflect the quality of the care you receive.
Myth: If there is a big difference between your fees and the amount the insurance company will pay then your fees are too high.
Fact: Insurance company’s maximums have barely increased in the past 30 years! During that time, there have been many scientific advances in dentistry that we incorporate in our practice for your benefit. We provide 21st century dentistry, and we are certain you would not Like us to turn back the clock and only offer you what was available in the 1970’s.
Myth:I have 100% coverage.
Fact: There is no such thing as full coverage. However, we will do everything possible to help you maximize your benefits. We will work with you and offer you several options to help you stretch out your payments over time.