At Main Street Family Dentistry, as a courtesy to our patients, we will call your insurance company for you and try to learn as much as possible about the coverage and limitations of your insurance plan. We understand that the “fine print” of most insurance plans can be confusing, unclear, and overwhelming. We offer this service in an attempt to help you avoid surprises of non-covered services that need to be paid.
Your dental plan is designed to share in your dental care costs. It often will not cover the total cost of your bill. Most plans cover 80% to 100% for the initial exam and x-rays and 50% to 80% of dental services such as fillings, crowns, deep cleanings and dentures.
Let’s explain a few terms that you may encounter.
The portion of the dental bill to be paid out of pocket by the patient each policy year before insurance coverage begins. Between $25 to $250 is common these days for dental insurance deductibles.
The “maximum level” of reimbursement provided by your insurance. Annual maximums typically range from $500 to $2500 for most dental insurance plans. These maximums typically reset each calendar year, often on January 1.
If your plan is a PPO, your plan may want you to choose your dental care from a list of their preferred providers. Complete Care Dental is a preferred provider for most major dental plans in our area.
Least expensive alternative treatment or alternative benefit
Your plan may only cover the least expensive treatment for a condition. For example, your dentist may recommend a crown, but your insurance may only cover a large filling. As with other purchases, the least expensive option may not be the best option.
Exclusions or non-covered services
Many dental insurance plans do not cover certain preventative treatment, such as sealants, that can keep you healthy and save you money down the road. Your dentist can help you decide which treatment is best for you.
We will work hard with our patients to identify the best treatment options to fit their conditions, lifestyle and budget. While we do our best to clarify insurance coverage issues, it is ultimately up to the patient to remain informed as to the specifics of their insurance policy.