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How to Decode Dental Insurance

Many of us are lucky to have dental insurance to help cover the costs of our regular dental visits, but when unexpected charges come up it can be difficult trying to figure out the reason why.

We try to get as much information as we can to help. But there are hundreds of different insurance policies and although some may give us very limited information; others give us none due to privacy acts they have in place.

Most insurance policies will allow you to come in for regular exams and cleanings, as well as some restorative work (if needed). But each plan covers the charges at different percentages as well as at different rates.

Even if your plan tells you they cover 100% that is almost never; they choose to cover 100% of their fee guide.

Another layer insurance policies add on to coverage is a yearly maximum. Again each plan has a different maximum and this is nearly impossible for your dental office to tell. Your insurance will never cover more than the maximum.

You can keep track of your yearly maximum by:
• Calling your insurance company and finding out how much your max. is, and how much is remaining.
• Logging onto your company’s website/app and checking on there.
• Adding up the visits they have paid for and subtracting from your annual max.

We have a quick form here that you can complete to help keep track of what your insurance may cover.

Remember “you’re due” doesn’t always mean “you’re covered”; and at the end of the day your insurance plan is a contract between you and your employer, not your dentist.

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