Dental insurance is a benefit provided by many employers. However, dental benefits differ greatly from traditional medical benefits and can vary quite significantly from plan to plan. The recommendations we make regarding your treatment and the fees we charge are not based on what your insurance will cover but are based on your individual needs. Our office will do everything we can to insure that you get every benefit dollar you are entitled to and will assist you in the filing of your dental claims, but encourage you not to compromise the kind of treatment you receive based on your insurance coverage. You will always make the ultimate decision regarding the level of care you would like to receive and how quickly you want our office to proceed. Please keep in mind all charges are your responsibility from the date services are rendered.
Having prior knowledge of what your insurance coverage is all about can be very helpful. The following are facts about dental insurance that you should know:
Facts About Dental Insurance
Fact #1: When dental insurance plans began in 1970 they allowed the same amount of maximum payment per year as allowed today. Allowing for a conservative 6% yearly rate of inflation, your yearly plan maximums should be in excess of $4500 today but are not.
Fact #2: You may receive a notification from your insurance company stating that dental fees are higher than usual and customary. Insurance companies never reveal how they determine usual, customary and reasonable (UCR) fees. They are determined by taking some percentage of an average fee for a particular procedure in a geographic area. We do not provide average dentistry nor do we charge average fees.
Fact #3: Many plans tell their participants that they will be covered up to 80% or 100%, but do not clearly state plan allowances or other limitations. It has been our experience that realistically, you can only expect to receive 35% to 50% of the services that will be provided for you. You only get from your policy, what your employer puts in, minus insurance company profits.
Fact #4: Insurance companies do not cover many routine dental services. This does not mean that those services arent necessary or appropriate; they are just not covered by your plan.
Our suggestion is to consider your benefits as a supplement or partial reimbursement for your treatment and not a passport to discounted care. The latter devalues the treatment and doctor and does not benefit you.
We understand the kind of burden that health care expenses can place on your budget and will be happy to assist you in the management of your account. We will help in every way by filing your claims, handling insurance queries, writing letters, processing follow up requests, resubmitting claims, etc. We are here to help you not only achieve and maintain your oral health but to comfortably deal with any financial concerns you may have along the way.
Call us with any questions or to make an appointment.212-246-1333