You and Your Dental Plan
Dental insurance plans are a valuable extended health benefit, offered to help offset some of the costs associated with dental care. Understanding your plan coverage, will help you with treatment decisions, prior to proceeding with dental work. Coverage will vary based on the plan purchased for you, by your union or employer, or yourself. Most standard plans cover basic work at 80% including exams, x-rays, cleanings, fillings and root canals. Standard plans might cover major work at 50%, which includes more complex treatment such as crowns, bridges and dentures. Other plans, with higher monthly premiums, might cover basic work at 100% and possibly 60% or higher for the major category. The patient is responsible for any costs not covered by the dental insurance plan. Remember, that it is the plan purchaser who determines what is covered when they choose a plan, not your dental office. Your dental insurance policy will have many limitations, exclusions, and unique particulars, which we as dental providers are not privy to. As the consumer, you should research, and know your policy. You, as the consumer need to be as informed as possible about what your plan will cover, for you and your family.
Our dentists are highly trained professionals. Treatment recommendations are based on your dental health needs, not on what your dental plan will pay for. At Meadows Dental Group, we can help you understand your coverage, and we do our best to provide you with accurate estimates for recommended treatments. We will preauthorize major work, to provide you with estimated costs, prior to beginning treatment. As a convenience to our clients at Meadows Dental Group, we are happy to submit your dental insurance claims to your insurerm on your behalf. We will collect the insurer’s payment, for the procedures provided, and apply the payment to your family account. Please remember that any portion of the treatment fees, not covered by the insurer, are your responsibility.
We strive to keep our clients information regarding insurance, updated and current. But, if any information does change, for example, a change in employment, change in the dental plan carrier, or a change in address please inform our office promptly. Changes in coverage can effect estimates, and keeping current will expedite the submission and processing of claims, and therefore the payment of claims.
Most importantly, we are committed to providing you, and your family with the best dental care. Our obligation is to you, our clients, not the dental plan. We will base our treatment recommendations on your dental health needs, and you provide you with treatment options, if applicable. We will provide you with estimates for any recommended work, to the best our our ability. This is based on your needs, which may or may not be what your dental plan will pay for. After discussion with your dentist, and after being provided with all the information pertinent to the treatment recommendations, you have the right to accept or refuse treatment.
In a Nutshell
- Know your dental plan and what is covered before your dental appointment, to understand your portion of the cost. The insurance plan is YOURS, not the dental offices’.
- Discuss all treatment options with your dentist to make an informed decision based on your dental health needs. Understand any health risks associated with delaying or declining treatment.
- Pay the required co-payment. You expect your dentist to be honest with you about the care you need, and so does the insurance company.
- Prevention is still the best treatment for everyone in your family. Brush and floss daily, limit sugary drinks and snacks, don’t smoke and have a dental exam at least once a year to diagnose problems before they become more complex and costly.