Dental Insurance is a contract between your employer and a dental insurance company. The benefits that you receive are based on the terms of the contract that were negotiated between your employer and the dental insurance company and not your dental office.
The goal of most insurance policies is to provide only basic care for specific dental services. The services selected are based on the cost of the policy to your employer and the negotiated arrangements with the dental insurance company.
The benefits that you receive from the dental insurance company have nothing at all to do with you or achieving a high quality complete result.
Because the benefits you have are decided between your employer and the insurance company, many services are not covered. The selection of non-covered services is not based on what you need or want, but is based strictly on the contract with the insurance company.
This is why so many dental patients become confused about dental insurance. Dental insurance companies rarely cover 100% of your dental fees and, in many cases, cover less than 50% or nothing at all.
Covered and Non-Covered Services
Unfortunately, some of the services that you may need or want will not be covered by your dental insurer. Our goal is to help you achieve and maintain optimal dental care, which is not necessarily the goal of your dental insurance company. The goal of the insurance company is to provide only the negotiated benefits for the specifically stated services.
The reimbursement mechanism from your dental insurance company is merely a mathematical formula as to which benefits you will receive and the percentage of the dentist’s office fee that will be paid. We do not want to compromise your care based on restraints placed by an insurance company.
Another fact that most dental patients do not realize is that each dental insurance plan has a dollar amount limitation each year. Once this amount is reached, no other services will be covered by your dental insurance company regardless how essential the service may be to your dental health.
