So you’ve got dental insurance…great! Do you understand your dental benefit? If you’re like most of our patients, your knowledge of your benefits has a few gaps. Maybe you feel like you should know more because we make it look so easy. We’ve got some tips for understanding your dental benefit.
Understanding Dental Insurance
Let’s start with the definition of insurance: It’s a promise for compensation for potential specific future losses in exchange for periodic payment. Typically, when we think of insurance, we think of protection against catastrophic, unpredictable loss. Auto insurance protects against that big accident, homeowners insurance protects against a flood, or your health insurance covers expenses relating to an illness or disease. Since most dental needs and treatments are predictable and non-catastrophic, it is probably more accurate to dub dental insurance as “dental benefit”.
Your dental benefit is a contract between your employer and a dental insurance provider. The amount of the benefit is decided upon between the employer and insurance, based on how much your employer wishes to pay in premium costs. Then your employer offers you that dental insurance policy as an employment perk.
Insurance company —–>Employer —->You.
We bill insurance companies for your treatment as a courtesy to you, but we are in no way “affiliated” with your insurance policy. We have contracts with certain dental insurance companies that make us “in network” providers. In a nutshell, this means that we have negotiated a fee schedule for dental services with that insurance company and that means a better deal for you. But it does not make us party to your dental insurance contract. If you are in any way unsatisfied with your dental insurance coverage, you should discuss it with your employer.
Our goal is to optimize your dental insurance benefit without sacrificing quality dental care. Sometimes, that means that the treatment Dr Willis recommends is not a covered benefit under your insurance policy. That doesn’t mean that the treatment isn’t appropriate or needed, it just means that the insurance won’t help you pay for it.
Next, we’ll give you an overview of general policy benefits….stay tuned!