So
you’ve got dental insurance…great! Do you understand your dental benefit? If
you’re like most of our patients, your knowledge of your benefits has a few
gaps. Maybe you feel like you should
know more because we make it look so easy.
We’ve got some tips for understanding your dental benefit.
Understanding
Dental Insurance
Let’s start with the definition of insurance: It’s a promise
for compensation for potential specific future losses in exchange for periodic
payment. Typically, when we think of
insurance, we think of protection against catastrophic, unpredictable
loss. Auto insurance protects against
that big accident, homeowners insurance protects against a flood, or your
health insurance covers expenses relating to an illness or disease. Since most dental needs and treatments are
predictable and non-catastrophic, it is probably more accurate to dub dental
insurance as “dental benefit”.
Your dental benefit is a contract between your employer and a dental insurance provider. The amount of the benefit is decided upon between the employer and insurance, based on how much your employer wishes to pay in premium costs. Then your employer offers you that dental insurance policy as an employment perk.
Insurance
company ----->Employer ---->You.
We bill insurance
companies for your treatment as a courtesy to you, but we are in no way
“affiliated” with your insurance policy.
We have contracts with certain dental insurance companies that make us
“in network” providers. In a nutshell, this means that we have negotiated a fee
schedule for dental services with that insurance company and that means a
better deal for you. But it does not
make us party to your dental insurance contract. If you are in any way unsatisfied with your
dental insurance coverage, you should discuss it with your employer.
Our goal is
to optimize your dental insurance benefit without sacrificing quality dental
care. Sometimes, that means that the
treatment Dr Willis recommends is not a covered benefit under your insurance
policy. That doesn’t mean that the
treatment isn’t appropriate or needed, it just means that the insurance won’t
help you pay for it.
Next, we'll give you an overview of general policy benefits....stay tuned!