Dental insurance is not exactly insurance – it’s more like a gift certificate.
It’s important for you to know the basics about your plan, however only you and your dentist should decide what treatment best meet your dental needs. Most dental insurance policies are designed to provide only basic care for specific dental services. The services which are selected are based on the cost of the policy to your employer and the negotiated arrangement with the dental insurance company.
Dental insurance companies rarely pay 100% of any dental fee. Most plans use what is called “usual, customary and reasonable,” or UCR. Exceeding the plan’s UCR fee does not mean that your dentist has overcharged for the procedure. The plan pays a set percentage of the dentist’s fee or the plan administrators UCR fee limit, whichever is less. These limits are the result of a contract between the plan purchaser and the insurance company. There is generally a dollar amount that the plan will pay out each year. Once this limit is reached, no other services will be covered, regardless of how necessary the service may be to your dental needs.
There are some contracts, such as Preferred Provider Organization (PPO) program in which patients are given a financial incentive to go a provider that has chosen to participate within that PPO program. Dr. Khalil is participating with Delta Dental and Met Life plans.
It is our goal it to help you achieve and maintain the best dental care possible. We know that dental insurance may be difficult to understand and are committed to assisting you to maximize the benefits in which you are entitled.
Written by: Christine Bracken