Understanding how your dental benefits work is essential to making sure your experience at the dentist goes smoothly. Here are some things to think about when it comes to dental benefits.
Your dental benefits are nothing like your medical insurance coverage.
Medical benefits afford you a discounted fee until you meet your deductible, after that time your Medical Coverage really kicks in and there usually is not a maximum coverage that the insurance company will provide.
Conversely, dental benefits are more like a group discount.
When you are a member of a group that an insurance carrier covers, you essentially get a discount for belonging to that group. Each group has a negotiated contract with the carrier on what the terms of the coverage will be. Deductibles, maximum coverage, and terms of coverage are all part of a contract between the carrier and the group administrator (usually someone in your HR department at work). On the patient care side, dentists sign contracts with the insurance companies to be considered in-network providers. By selecting in-network providers, covered individuals ensure they will best use the dental benefits available to them.
Some general things to know about dental benefits:
- Yes, dental benefits have a maximum coverage. Once you have reached your maximum benefit (usually $1000, $1500, or $2000), you are responsible for the remaining (still discounted) fees and will pay for them out of pocket.
- Your deductible must be met before your coverage goes into effect. Your dental care provider must collect your deductible. Usually this amount is either $50 or $100 dollars.
- You get to choose who your dentist is—even if they’re out of network. Going to an out of network dentist still allows you coverage, but the portion you are responsible for may be greater.
Responsible care providers know that the patient is in control.
Patients choose what their treatment is and who will administer it, regardless of what their benefits carrier says. It is always a good idea to call your dentist before your appointment to verify that they have your insurance information correct. Visit our Financial Page to see some of the carriers that we are in network with!
Give us a call today at 314-961-0020 to schedule your dental cleaning appointment today with your favorite Webster Groves Dentist!