Understanding Dental Insurance

 

To ensure that you have the best dental experience and the right expectations, we want to share some of the things we’ve learned working with dental insurance companies.

 

To start, the amount of your coverage is based on how much your employer budgeted for buying insurance. The amount of coverage is not based on your dental needs since no one from your insurance provider checked your teeth and medical history or what kind of coverage was needed for your dental needs. That’s where we come in.

 

Our job is to make recommendations based on what’s best for your oral health, not whether if it’s covered on your insurance policy. We want to help you to better understand your mouth and the best practices to achieve optimal oral health. That's why we will work with you and go over all of your options before deciding on a treatment plan.

 

We understand that most patients want the best dental care done right from the start. And it’s our job to give it to them each and every time. That’s why we encourage our patients to take an active role in their oral health and to look at dental insurance as an aid to help them achieve their goals. Dental insurance was designed to cover only some of the treatments' costs, never to cover the full amount.

 

Our team has plenty of experience working with dental insurance providers and we’ll be glad to help you too! We want to make the whole process easy, smooth, and enjoyable. We can help you determine what you’re entitled to under your plan and clarify any questions about your coverage. We’re here to help you to ensure you get the most out of your dental insurance so you can achieve optimal oral health.

 

Important facts you should know

 

In some cases, your dental benefits coverage may be reduced due to cutting costs. That means that treatments and services that were covered before may not be covered anymore. That’s why it’s important to stay up to date with your benefits’ terms and conditions.

 

Unfortunately, if there are any changes to your insurance policy, they won’t tell us. Please inform your dentist  or receptionist if there are changes to your policy or service provider.

 

Dental insurance coverage rarely covers 100% of your treatment costs. This means that you’re ultimately responsible for paying your co-pay.

 

Your insurance coverage is a contract between you, your employer, and insurance provider. Your dentist has no control over how much coverage or what services are covered under your benefits plan.

 

We would be more than happy to send a pre-authorization to your insurance provider to confirm your coverage for a treatment or service. This will allow you to budget and plan your finances prior to receiving treatment.

 

To have a better understanding of your insurance policies, here are some commonly used insurance terms to know:

 

ANNUAL MAXIMUM - This is the maximum amount of annual coverage you have under your insurance policy. Please keep in mind that this coverage can be changed by your provider so it’s important to stay up to date with any changes.

 

DEDUCTIBLE - The amount that you pay for your treatment prior to when your coverage begins.

 

ELIGIBILITY - The parameters that determine who is eligible to be covered under the insurance policy.

 

EXCLUSIONS - It's likely that not all dental treatments and services are covered by your dental insurance. These exclusions are because insurance companies want to save money. Be sure to go over your insurance booklet to check what services and treatments are covered.

 

CO PAYMENT - Dental insurance rarely covers 100% of total fees for treatments or services. Co payment is this is the amount of a treatment fee that you are expected to pay for that is not covered by your dental insurance.

 

DUAL COVERAGE - when both you and your spouse are covered by different insurance plans. The insurance companies will then work out the benefits so that you don’t have to pay for more than 100% of the treatment’s fees.

 

Insurance Provider Contact Information

Use this handy list of  questions to help us understand your coverage - VIEW

 

Below are the phone numbers for the most common insurance providers:

 

Great West Life - 1-800-957-9777

 

Blue Cross - 1-800-667-4511

 

Manulife - 1-888-844-8889

 

Sunlife - 1-855-301-4786