A common question…with a not so straightforward answer.
Dental insurance is a benefit, usually provided by an employer, to decrease the cost of your out-of-pocket expenses. When a dentist is considered “in-network”, they have agreed to accept the terms of the contract with the insurance company, including their fees. Usually these fees are a negotiated price, typically lower than the traditional fee of the office. This fee is based on the plan the employer (or customer) purchases. When purchasing an insurance plan, employers usually look at the amount of benefit and the cost of the premiums for the employer and/or employee.
Some services are not covered, but does not mean they are not necessary. The insurance may decrease your out-of-pocket expense, but not cover it completely. As a trusted dental provider, we base treatment off of the best decision for your dental health. Some plans may state they cover preventative services (cleanings, x-rays, etc.) 100%, but the office fee may be more than the allowable fee of the insurance company. Even though you may have a balance with these services, it will always be less than the total amount, which saves you money in the end.
Here is a link for a glossary on dental clinical and insurance terms that can help you navigate your insurance.
Here at our office, we will file a claim with any insurance carrier, but we are only contracted with a few. Please call our office or send us a message on our contact page for any questions about your particular insurance!