Dental Insurance, What Should You Know
Dental insurance is not meant to be a pay-all. It's only meant to be an aid. You are very fortunate if you have dental insurance coverage and don't have to pay the entire dental fee plan out of your own pocket. Many patients don't have any dental insurance at all. Some patients have excellent dental insurance policies, some have fair policies, and some have poor policies. Many plans tell you you'll be covered up to 80% - 100%. In spite of what you're told, most plans cover only 15% - 70% of the average dental fee plan. We realize that every bit of help you get from your insurance company is a big help, and we are glad you have coverage. However, it must be understood that how much your policy covers has already been determined by how much your employer paid for your insurance policy. The less he/she paid for the insurance, the less you'll receive.
FOR EXAMPLE: PLAN Costs a lot of money Costs 1/2 the amount Deductible is $50.00 Deductible is $100.00 Pays $84.00 on a filling Pays $35.00 on a filling Yearly maximum is $1,000 Yearly maximum is $800 It has been the experience of many dentists that some insurance companies tell their customers that "fees are above the usual and customary" rather than saying "our benefits are low."
Your insurance company sets the "allowables" or " a usual and customary dental fee plan" depending on how much your employer paid for your policy. It's just like your car insurance. The lower the benefits you choose, the less it costs you in premiums. Many necessary routine dental services are not covered by dental insurance at all. Again, what is covered and what is not is determined by what benefits and dental fee plan your employer purchased for you.
We do not believe it is in your best interest for your treatment to be compromised in order to accommodate an insurance policy's restrictions that may provide you with a quality of care that is considerably less than you deserve.
We strongly feel that you, not your insurance company, should choose the treatment you feel is best for you.
DR. GARY SIGAFOOS