You pay your employer every month for dental coverage, but you may be a little bit in the dark as to what is actually covered. Many times, patients will discover the finer points of their policies only after a visit to the dentist — and often times are disappointed by the limitations. I encourage you to research the details of your coverage and talk with your dentist to make sure you know exactly what to expect before your dental bill comes.
Dental insurance is very different from medical insurance. With dental health benefits, the coverage works more like an allowance, given out only for approved procedures and treatments, with a maximum annual limit. Your insurance is a way to help you pay for the services rendered by the dentist, but very few policies will cover 100% of dental services.
At our Boulder dental clinic, my team and I try to help our patients maximize their benefits, regardless of the type of insurance they have. Many people assume that dental providers have some sort of pull with the insurance companies, but we are really just third party in the equation. You as the patient pay the premiums and have the relationship with the company. You have to take things into your own hands and be willing to stand up to your insurance provider when they attempt to deny or limit benefits that are clearly stated in your policy.
When you visit us for your first dental visit, we can review your policy together to ensure you are prepared to pay whatever is required. We can also make calls to your insurer if there are questions about coverage before services are performed. We’ll also help you understand various tactics used by the insurer to avoid paying out too much — for instance, many policies will only cover metal fillings. However, they may let you apply the metal allowance to a tooth-colored filling instead, where you are responsible for paying the difference. You should also be aware that “preauthorization of treatment” is often used as a stalling tactic on the part of insurance company so that they can find loopholes in your policy wording to avoid payouts.
If you are interested in payment assistance, we can also discuss your options for dental financing.
If you’d like to come in for a wellness check or to address a dental issue, please schedule an appointment. We are happy to go over your insurance plan with you to identify your coverage specifications and help you understand your policy.
