First
Choice Dental Center
Where Grins Begin!
• Your dental benefits are based upon a contract made between your employer and an insurance company (or yourself and the insurance company in the case of an individual plan). Our staff can answer many questions about your plan, but since we are not party to the contract, most questions about your plan should be directed to your employer or the insurance company directly.
• Dental benefits differ greatly from medical benefits. In 1959, most dental benefit plans had a yearly cap of $1000. You may be surprised to know that the average dental benefits plan of today has a yearly maximum of $1000. There has been no significant increase in the yearly maximum cap for over 40 years! However, there have been significant increases in policy premiums. Dental benefits will never pay for completion of your dental care. It is only meant to assist you.
• Insurance companies DO NOT cover many routine and newer dental services.
• Many people receive notification from there insurance company that dental fees are "above usual and customary". An insurance company determines their reimbursement level by surveying a geographical area, calculating the average fee, then taking 75% - 80% of that average fee and setting it as the usual and customary fee for that area. Included in this survey are discount dental
• Many dental benefit plans tell their participants that they will be covered up to "80% or 100%" but do not clearly specify the plan fee schedule allowance, annual maximum, or plan limitations (such as non-metallic crowns on molars). It is more realistic to expect dental benefits to cover between 25% and 40% of most dental services. Remember that the amount a plan reimburses is determined by how much your employer has paid for your dental benefit plan. You will only get back what your employer has put in, less the insurance company's profit margin.
• Your insurance company is not a party to your treatment evaluation. They do not know your current health status, your best treatment options, or your long term prognosis for varying treatment options. They evaluate payment of dental claims based on the limitations set forth in your plan contract. In no instance will anyone from the insurance company consult with the doctor on your best treatment options. If you desire a second opinion, your best option is to see a specialist of the treatment in question.
Our office staff will gladly assist you in maximizing your dental benefits and discussing your financial options. Excellent dental care is available with or without dental benefits. We hope that you choose the best modern dentistry has to offer.