Merion Village Dental Blog

Many people often take a simplistic view when it comes to dental insurance. They might assume that any dental treatment they might need will be fully covered just because they have coverage through their employer.

However, that is not always the case. In reality, dental insurance can be just as complicated as medical insurance. Here are ten pieces of dental insurance advice you should consider before your next dental appointment.

Dental Insurance is Different than Medical Coverage

While health insurance is meant to support you in the event of a major illness or accident, dental insurance is about ongoing care. This can include two annual exams and/or cleanings, x-rays, and possibly fluoride treatments if needed.

When it comes to a major treatment, however, such as oral surgery, a crown, etc., dental insurance is not designed to completely cover your costs.

The Penalty for Going Out-of-Network is Often Small

Just because your insurance provides a list of participating dentists and offices, it does not mean using them is a requirement. Often times, the network provider fees and the out-of-network provider fees that your insurer will cover are exactly the same.

Coverage Has Not Kept Up with Inflation

Look at some economic trends for our country, and you will see that few services have the same dollar-value that they used to have. Well, except for dental insurance plans, that is.

In the 1970s, most dental insurance covered up to about $1,500 annually. Keep in mind, this was back when a gallon of gas was roughly $0.74. We all know where gas prices have gone, but when it comes to dental coverage, insurers still only provide about $1,500 annually.

Dental Insurance Will Not Cover Most Emergency Services

Dental coverage acts more like a coupon – since most plans have yearly maximums or deductibles, it acts to aid payment rather than to completely cover costs.

Dental Insurance is Designed for Preventative Care

Dental plans often break down procedures into a “class of service,” designating each class as either diagnostic and preventative, basic restorative, or major and complex. Class 1 procedures (preventative care) are usually covered close to 100%, while Class 3 procedures (major restorative) are often only covered at 50 percent.

It is Often the Patient’s Job to Submit Claims

Unlike health coverage, when a dental claim is paid, the patient is usually contacted with an explanation of benefits before the dentist is. At Merion Village Dental, however, we realize this might be overlooked – so we submit your claim for you.

Insurance Companies Keep Secrets

Finding out the exact cost of your co-pay for a procedure can be difficult – insurers often do not disclose their actual payment tables until after the payment has been processed.

As a courtesy, we provide a complimentary benefits check for all of our patients to give you the best estimate possible based on previous claims.

Companies Are Reducing Benefits

Although dental plans can vary widely, the trend has been for benefits provided by insurance companies to be steadily reduced. We work hard to help you maximize the benefits you do have and to make the best use of your plan.

They Work Hard to Deny Payment

It probably will not come as a surprise, but dental insurers (just like other insurance providers) do everything they can to deny or disqualify a claim.

Our answer to this fact is hard data – through the best technology available, such as digital x-rays and high-definition radiographs, we work to make your condition clear and indisputable.

Options Besides Dental Insurance

At Merion Dental Village, we are committed to your dental health first and foremost. To this end, we offer payment plans designed to fit your needs, such as financing options. Contact our office any time for a complimentary benefits check.