First Choice Dental Center
Where Grins Begin!
IF YOU HAVE DENTAL BENEFITS, HERE ARE SOME THINGS YOU
SHOULD KNOW!
At
FIRST CHOICE DENTAL CENTER we believe you deserve the very best care.
That is why we always present you with the best dental solution to treat your
personal situation. Each year we provide outstanding care to hundreds of people.
Some have dental benefits, but most do not. If you have dental benefits,
congratulations! You are very fortunate. Here are some important things you
should know...
• 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 clinics and managed care facilities
that significantly impact the average. Any doctor in private practice will
have fees that insurance companies define as higher than "usual and
customary".
• 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.