Employer sponsored insurance policies are a contract between your employer and the insurance company.  Therefore, covered services can vary greatly from policy to policy.  We are able to contact your insurance company by phone or online to determine if particular services are covered or not under your contract, but we may not know exactly what dollar amount is covered.  This is because your policy will only pay what your employer and the insurance company have agreed to.  For example:

  • Employer ‘A’ and Employer ‘B’ both contract with the same insurance company.
    • Employer ‘A’ agrees to a policy that covers 100% of your exam cost up to $48.00.
      • You go to the dentist and your exam cost is $45.00. Your insurance company pays $45.00 and you pay $0.
    • Employer ‘B’ agrees to a less expensive policy that covers 100% of your exam cost up to $30.00.
      • You go to the dentist and your exam cost is $45.00. Your insurance company pays $30.00 and you pay $15.00.

 

For more expensive procedures, we can send a pre-treatment estimate to your insurance company.  This process takes 2-4 weeks and will allow us to know exactly what dollar amount is covered and what your copayment will be.  This is a good option for non-urgent dental needs.

 

Something to think about – The dental insurance industry as a whole has neglected to increase coverage and benefit levels pretty much since the beginning.  Meaning, the coverages and annual maximum benefit that you receive in 2015 is likely the same as it was in 1995, even though technology, treatment recommendations and cost have changed significantly over these years.