Insurance University, Part 2: The Challenge of Dental Insurance
May 18th, 2012
With all the variety of dental plans available, figuring out benefits can be very challenging. Each will cover a maximum amount, more than likely have some type of deductible, and cover a specific percentage toward preventative cleanings, exams, and x-rays, basic which covers fillings, root canals, and periodontics, and lastly major which covers crowns, bridges, implants, and dentures. If you go to a specialist or transfer from another dentist and have used some benefits, that accrues towards your overall maximum.
If you are co-insured, there is no guarantee that the secondary insurance will pick up the balance or pay any benefits towards the original claim. Sometimes there is a clause stating there is a non duplication of benefits. We can also do a pre-treatment estimate so we can get a better idea of what your out of pocket may be. However, a number of factors can influence the final cost of your treatment, so this estimate is not a guarantee of coverage. For example, insurance may not cover pre-existing conditions or limit the number of times it will pay for treatment. This could happen if it’s been recommended you have three cleanings a year, but the insurance will pay for just two. You and your dentist will ultimately have to decide what’s best for your dental health, and this doesn’t always align with what the insurance company is willing to cover. As always, we are here to help you maintain a healthy and happy smile, so don’t hesitate to ask for clarification or recommendations.


Good dental health requires only a few minutes of your day. Today, I thought I’d provide some practical advice on how to improve your or your smile between your