We are always getting questions about insurance. We did have a blog post about this back in May, 2016, but still there is much confusion, so I thought I would try to shed some more light on dental insurance.
As we mentioned in our first blog about insurance, dental insurance started in the 1970’s and the benefit hasn’t increased since then, still between $1,000 and $1,500 per year. And, you can’t use this without restriction and limitations. So, we have now decided to term “dental insurance” more of a coupon for dental care. Let me try to explain this. You have $1,000 in coupons that you can use per year. Now, your cleanings, x-rays, and exams are covered almost entirely by your coupon, so you will have little to pay out of pocket for these procedures. We recommend that you take full advantage of this! Your 2 cleanings and exams will be the best value for your coupon. BUT, the cleanings and exams do count to your total coupon value of $1,000. When we move into discussing fillings, your coupon will cover some of the cost, but your co-pay, the amount you pay out of pocket, will be greater. Again, you still only get $1,000 per year. If you need major work such as; crowns, dentures, bridges, or implants, this coupon covers even less, meaning that your out of pocket expense is more. Most of these procedures are over your $1,000 per year each, so the coupon will help, but doesn’t cover very much.
The other confusing part is we can’t tell you how much your coupon will cover for any procedure. Your insurance company uses their own formula for deciding what they will cover and how much they will pay for each of those services. You do need to remember, your insurance company is in the business to make money, not to pay for your work, so they will pay for as little as possible.
In conclusion, we will work to get you as much as we can from your insurance for each visit. We will file the claims, call when we need to, and write letters on your behalf to get you everything that we can.
If you have any questions about your insurance, or would like to find out more about our office, please give Bettina a call at 978-401-9081.
I would like to thank one of my colleagues- Dr. Mac Lee for the resource to help write this post.
-Dr. McDowell
