Dental Insurance Information

How does dental insurance work?
Dental insurance isn't insurance at all, it's actually a benefit plan, like a gift card from your employer. Only about half of employers actually offer dental insurance. Most dental benefit plans have a yearly maximum of $1500 and will not pay anything over that whether it's dentally necessary or not. This number hasn't changed in 40 years despite increasing premiums and the cost of providing dentistry, and the average dental plan has become more restrictive on what they pay for. With most dental insurance, we can get an estimate from them on how much they will pay for your dental care, and we can collect your portion at the time of service. For patients with Delta Dental, we will collect the full payment at the time of service, and Delta Dental will send the reimbursement payment directly to the patient 7-10 business days later. For patients with more extensive dental needs who need to finance their portion of treatment, we offer flexible financing through care credit

Which dental insurance plans do you take?
We accept all dental plans which allow you the freedom to choose your own dentist. We do not directly contract with any dental plans which require us to discount our dentistry to appear on their advertising lists. This allows us to be transparent with our pricing and provide dental care which is highly tailored, of exceptional quality, and provided in a way that's gentle and not rushed. Most plans, with the exception of HMO plans, allow patients to choose their own dentist and dental care that best fits their needs. Different plans from the same employer and even same insurance carrier can vary widely on what they provide. For questions on the details of your specific plan, please contact us for help on how your plan works with our office.

How do I decide which plan to choose among the various plans my employer offers?
A good dental plan should allow the patient to choose their own dentist with few or no restrictions. Better plans will reimburse based on the average fees for an area. What they often don't tell you is they will only pay 100% of a capped fee, whereas a better plan will pay 100% of the average fee for the area. Ask to compare the maximum allowances for more common procedures like exams, cleanings, fillings, and crowns.

Most plans allow for the patient to choose an office to send the benefits to, which is called "assignment of benefits". Most plans allow for the assignment of benefits to the dental office they choose regardless of the dentist's participation in that insurance plan, with the exception of Delta Dental.

If your plan does not allow you to choose your own dentist, pay fees based on the average for an area, or assign benefits to your dentist, please speak with your employer about other options they may be able to provide.

My employer doesn't offer a dental benefit plan, what are my options?
Some employers are choosing flex spending plans which cover dental care instead of traditional benefits. Others offer direct reimbursement plans for dental treatment at a dentist of your choosing.

If you are self employed or your employer does not have these options, consider a health plan that allows for a Health Savings Account (HSA). Each year you can contribute a tax deductible amount that you can use to pay for dental care. Money that isn't used continues to accumulate interest, and money in those accounts often is allowed to roll over to the next year.

Folks often ask if there's a dental plan we recommend, and we have not found a plan that makes sense for an individual to buy. Most plans charge more in premiums than they actually pay back between non covered services, waiting periods, and other restrictions. With a large group plan through an employer, the large number of employees who do not go to the dentist pay for the loss that insurance would incur if everyone on the plan went. For individual plans, insurance has to pay less to the dentist than the collected premium.

Of course the best plan for reducing the cost of dental care is prevention. Good oral hygiene, avoiding snacking and acidic drinks between meals, and reducing risk factors like dry mouth are the best ways to reduce overall dental costs. Getting routine dental care and fixing problems when they are small ensure that what's missed at home is taken care of in the most minimally invasive way at our office.