With over 23,000 different insurance plans covering over 110 million Americans today, it is important that YOU read your policy and booklet carefully to maximize your individual benefits. Your policy is a contract between you and your insurance company to improve your dental health.
FACT #1 Dental insurance is NOT meant to be a pay-all, it is only meant to be an aid.
Fact #2 Many plans tell their insured that they will be covered "up to 80% or up to 100%". In spite of what you are told, we have found that many plans cover much less than that. Some plans pay more - some pay less. some insurance plans use a "fee schedule" and will only pay a percentage of that fee schedule not the filed fees, resulting in additional out of pocket expense for you the subscriber. The amount your plan pays is determined by how much your employer has paid for the plan.
Fact #3 It has been the experience of many dentists that some insurance companies tell their customers that "fees are above the usual and customary fees" rather than letting them know that "the insurance benefits are actually very low".
Fact #4 Many routine dental services are NOT covered by insurance carriers. Even with dental insurance you are still responsible for the entire cost of our professional services. Most dental insurance plans have policy limitation in dental treatment. Your insurance policy may not cover all dental services and/or may only pay a portion of the total cost of your dental treatment.
Fact #5 Many policies are restrictive in the doctors that you choose for your dental care. They will have lesser coverage if you go to an "out of network" doctor, and some may have no coverage if you choose a doctor that is not within their network. MAKE SURE YOUR POLICY DOES NOT REQUIRE YOU TO GO TO ONE OF THEIR NETWORK DOCTORS.
Here at Colorado Kids Pediatric Dentistry, we encourage all insured patients to be throughly knowledgeable about their coverage prior to their visit with our office. If you are unable to find the information you are looking for after reviewing your policy booklet, please feel free to call our office for assistance.