Insurance Facts
  • FACT: Your dental benefits are based upon a contract made between your employer and an insurance company. If you have any questions regarding your dental benefits, please contact your employer or your insurance carrier directly.
  • FACT: Insurance companies are in business for the sole purpose of making money. Their goal is not to provide you with the care you need or want, but rather to collect premiums and pay out as little as possible. Payment amounts are significantly reduced with excuses (or explanations) such as “fee schedule allowances”, “deductibles:, “annual maximums”, or “limitations”.
  • FACT: Dental Benefits differ greatly from medical benefits. In 1959, most dental benefit plans had yearly maximum cap of $1000. Still today, almost 50 years later, the average dental benefit plan still has a yearly maximum cap of $1000. That is $139 in “today’s” dollars. Dental insurance premiums, however, have risen over 600% in that same period of time. Dental insurance plans are not designed to pay all of your dental care, they are meant to pay only a portion of the fees.
  • FACT: Many dental benefit plans deceptively tell their participants (you) that they will be covered “up to 80% or 100%”, but do not clearly specify the plan fee schedule allowance, annual maximum, or limitations. It is more realistic to expect dental benefit plans to cover between 30% to 60% of dental services. Remember that the amount a plan reimburses you is determined by how much your employer has paid for your dental benefit plan. You will get back only what your employer has put in, less the insurance company’s profit margin. If you are dissatisfied with this reimbursement, please speak with your personnel department director, who can provide you with a proper, comprehensive dental benefit plan.
  • FACT: Your insurance is a contract between you, your employer, and the insurance carrier. We are not a party to that contract. If you have trouble with your insurance coverage, we ask that you speak directly with your insurance company. Your charges in our office are your responsibility from the date the services are rendered. Your treatment plan is not based on your insurance coverage; it is based on your needs and desires.

 

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