Will My Dental Insurance Cover Treatment?
Dental insurance is rapidly playing a larger role in helping people obtain dental treatment. Since we strongly feel our patients deserve the best possible care we can provide, and in an effort to maintain the high quality of care, we would like to share some facts about dental insurance with you.
FACT #1: Dental Insurance is NOT meant to be a PAY-ALL. It is only meant to assist you in the payment of your dental care.
FACT #2: Many routine dental services are NOT covered and are excluded or limited by the policy description. These services, when recommended, are necessary for your treatment and well-being. They should NOT be interpreted as “unnecessary” because the insurance company does not provide a benefit for them.
FACT #3: Many plans state that you will be covered “up to 50%, 80%, or 100%”. In spite of what you are told, we have found in actuality that many plans cover less than that depending on their own established fee schedule. The benefits your plan pays are largely determined by how much your employer/union is willing to pay for the plan. The less they pay for the insurance plan, the fewer benefits you will receive.
FACT #4: Insurance companies establish “Usual and Customary” fee schedules that may or may not have an accurate relationship to what are the “Usual and Customary” fees where you live. Insurance companies often will tell their members that their provider’s fees are “above what is usual and customary” rather than say, “Our benefits are low”. This may be because there are various ways insurance companies establish their usual and customary fee schedules. In fact, frequently different insurance companies in the same geographical area will have different usual and customary fees. Our fees may be within one company’s usual and customary fees and not another insurance company.
We strive to provide you with the very best of our care, skill and judgment. The insurance company is in the business to make a profit from selling health care. We believe that is why they:
- Exclude a benefit from your policy.
- Limit the benefit maximum on an annual basis.
- Provide only a small amount of coverage.
- Recommend alternative procedures to limit benefits.
Carefully consider whom you want to be making your health care decisions – the insurance company or your own personal doctor. You can count on us not to compromise your diagnosis or treatment.
You can call Sanchez Dental Associates to arrange for a free consultation. We’ll talk to you about your unique situation and figure out the best way to take care of your smile.