Yeah! Dental insurance…or so you thought, right? You have chosen the option to pay a company to handle your dental bills at a premium and then, Wowza! You got billed.
Have you had an experience in which your insurance plan states it will cover 100% of a procedure but you still wind up paying?
For example:
Your 6-month cleaning and exam are $10 (you wish!) and you graciously pay upon leaving the appointment. The dental office coordinator submits the claim to your insurance company and in a week’s time, your reimbursement check shows up!
It’s only $4.
Your first thought “Woah… my plan says 100% coverage, why am I out $6?”
Here’s why: Insurance companies have a set of fees they feel a procedure is worth and they are willing to pay. On the other hand, every dentist has a set of their own fees. Why are fees sometimes dramatically different, like the example above, you ask?
One GIANT reason, YOUR HEALTH based on their business model.
Unlike the dentist:
- Insurance hasn’t looked inside your mouth
- Insurance hasn’t reviewed your health history
- Insurance hasn’t formed a cherished relationship with you.
We have gone above and beyond to partner with you in your dental health. Your health is taken into account before any procedure is done, and we give you the best options in dental care.
Can you honestly say you would want the insurance company to choose and assign what is best for you and your family, or would you rather choose the dental team, that partners with you?
We thought you’d agree, but here’s an example to hit the nail on the head.
You’re at your 6-month cleaning and your dentist detects a cavity that you will need to have filled. You discuss your options with your dentist and decide a composite (tooth colored filling) is best for you, as opposed to an amalgam (silver) filling. Your benefit plan only allows coverage for the cheapest way to treat your dental procedure, despite what you and your dentist have already discussed.
Your insurance plan says they will cover 50% of a composite but 80% of a silver filling, meaning you will get a larger reimbursement check if you put a silver filling in your mouth.
Well, who doesn’t want more money back?
It may initially seem like a no-brainer but you may want to pump the breaks and investigate why your insurance company has a say when it comes to determining what is best for your health.