We feel that dental insurance is a significant asset in helping patients with the cost of dental treatment. For this reason, we will always be an advocate for our patients to help maximize their insurance benefits.

Dental insurance is a valuable benefit that you may receive as an employee of your company.  It is valuable since it helps you maintain your oral health.  In most instances, dental insurance is something that you pay for directly or indirectly.  For this reason we take this important benefit seriously.

Many patients, however, confuse dental insurance with medical insurance.  There are two important distinctions between them.  Unlike medical insurance, which pays the majority of medical care, dental insurance will only pay to the limit which your employer purchases.  Secondly, dental insurance isn't really insurance (defined as payment to cover the cost of a loss) at all. It actually is a benefit, typically provided by an employer, that helps employees pay for routine dental treatment.  The employer usually buys the plan based on the amount of the benefit and how much the premium costs per month.  Most benefits plans are only designed to cover a portion of the total cost of treatment.

Insurance companies use what is called a "usual, customary and reasonable (UCR)" fee schedule to decide what portion of the dental treatment will be covered under the plan.  However, this does not mean exactly what it seems to mean.  UCR is actually a listing of payments for treatment negotiated by your employer and the insurance company.  The payment listing is related to the cost of the premiums, and the geographical area where you live.  In almost all cases, the payments are usually less- and frequently much less-  than what any dentist in your area may actually charge for these dental procedures.  The exception to this rule is when you and the dentist are a members of a Preferred Provider Organization  (PPOl).  In this instance, the dentist has agreed to accept the fees provided by the network carrier and cannot balance bill you for the difference between his or her fee and the fee allotted by the insurance carrier.  The only portion for which you would be billed is your co-payment for the dental procedure.

It is important to remember that unused benefits at the end of a contract year cannot be carried over to the next year.  Therefore, those benefit dollars are lost if not used.  We urge you to think about this fact when deciding on treatment options for that calendar year.  Finally, regardless of insurance coverage the treatment that we recommend is in your best interest.  The insurance company has not examined your and your needs.  They can only apply a procedure code number to a set of guidelines established by your plan administrator.