From the Mouth

A Blog From Naper Dental Center

Blog - Does Your Office Take My Dental Insurance?

Yes, we accept all dental insurances and are always welcoming new patients. Your insurance will sometimes try to dictate which dentist you see and will have a list for you to chose from at times. However, that does not mean you cannot come to our office. We will gladly file to your insurance. You may have a little more out of pocket cost, but it is usually negligible in the big scheme of things. For example, your insurance may pay 100% of your cleaning at an office on their list and if you come here they may pay 90%. It is also important to remember that insurance plans usually only cover a percentage of the total cost of the treatment - ranging anywhere from as low as 20% to 80% and only up to certain monetary amount per year, usually $1,500.

The entire term “Dental Insurance” is a little misleading. Most everyone thinks of dental insurance in terms of medical insurance, where most all procedures are covered 100% once you hit your deductible or pay your co-pay. However, dental insurance doesn’t quite work that way and it hasn’t changed ever since its inception - from what it covers, to the monetary amounts it “allows” you to have. That’s why we like to think of dental insurance as more of a “Dental Benefit.” This “Dental Benefit” gives you a certain amount of money - let’s say $1,500 - to be used per year. Now most PPO plans will require that you meet a deductible each year, and you will still have to share the cost of treatment. This share is known as a co-payment and the percentage that you will owe differs between the type of procedure being done. It can be as low as 20% to as high as 50% OR the procedure is not covered and you will be responsible for the entire cost.

That brings us to the biggest point concerning dental insurance: they don’t really know what is best for your mouth and they typically cover what they consider the most common procedures. Something we recommend for a tooth or your whole mouth may not be covered by your particular insurance, either due to arbitrary timeline guidelines the plans follow or they haven’t caught up with dental technologies. It took many insurance plans years to cover a percentage of dental implants, and some still do not cover them. Even more disturbing, most insurance plans will not fully cover composite (tooth colored) fillings and will want you to have amalgam (silver) fillings placed in your teeth. Why? Because it’s cheaper for the insurance company.

Another unfortunate occurrence with offices that are in-network with all dental insurance plans is that their “allowed” amount (the amount the insurance allows a dentist to charge) for a crown, bridge, veneers, etc. is so low that it would not cover the lab cost for those restorations. This has caused many dentists to use lesser quality labs, most times sacrificing the esthetics of the restorations and sometimes use labs that are out of the country, in order to still be able to provide these procedures. We realize that esthetics are of utmost importance and we do not compromise on quality of our restorations and we proudly support dental labs in the United States.

That’s why at Naper Dental Center, we are in some PPO plans, but the majority of our patients come to us out of network or without dental insurance. They realize that their dental health is of extreme importance and that we are here to keep their mouth healthy and in the best shape - not to allow the insurance to tell us what is acceptable treatment. We do not let insurance dictate our treatment plans, but we will work with them to get you the most out of your Dental Benefit and help you obtain your healthiest, best smile.