What is Dental Insurance and How Does It Work?

Dental insurance is a highly complex area that creates confusion for many dental patients. The complexities of dental ins­urance and the lack of sufficient information provided by some insurance companies make it almost impossible to properly understand the benefits. Even more confusing is understanding how to properly work with your dental insurance company to achieve the highest level of benefits to which you are entitled.


What is Dental Insurance?


Dental insurance is a contract between your employer and a dental insurance company. The benefits that you will receive are based on the terms of the contract that were negotiated between your employer and the dental insurance company and not your dental office. The goal of most dental insurance policies is to provide only basic care for specific dental services. The services selected are based on the cost of the policy to your employer and the negotiated arrangements with the dental insurance company. The benefits you receive from the dental insurance company for your current insurance plan have nothing at all to do with you or achieving a high-quality complete result.


Pre-Determination Policies


Many insurance companies try to control the amount of dentistry you receive by requiring authorization for procedures in advance. Our office will do everything possible to help you maximize the insurance benefits to which you are entitled. In most cases, we can begin treatment prior to receiving an authorization from the dental insurance. However, patients need to understand that in the event the insurance company refuses to pay for treatment, you are responsible for all fees. As a third party, we can never guarantee payment for your treatment from any insurance company. Naturally, we always provide you with the full fees in advance so that you know the exact cost of treatment. Like you, we recognize that the authorization process is often time consuming and unnecessary.


Elective Treatment


Some services are typically not covered by dental insurance companies. These include: cosmetic dentistry, implants, occlusion or bite redesign, and other services. Although these are important dental services that can greatly enhance the quality of life of our patients, dental insurance companies do not feel that they should have to pay for these services. That is why these services are rarely included in contracts with your employer.






Ask Us For Help Any Time


Anytime you have a question about your dental insurance, please feel free to ask us. We recognize that dental insurance is becoming more complex and more difficult to understand everyday. That is often due to the quest by dental insurance companies to reduce costs through continual changes. Keep in mind that the dental insurance companies are not concerned about coverage for optimal dental care, but provide coverage for only a limited number of basic services.


Our Philosophy


Our office remains dedicated to providing optimal care for every patient. Our doctors will always recommend the treatment that is best for you as our patient, regardless of what an insurance company dictates as covered benefits. We pride ourselves in being available to help you in any way and continuing to provide you the quality of care in which you have been accustomed. Please let us know if you have any questions – it will be our pleasure to help you.

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