Understanding Your Dental Insurance

What does dental insurance typically cover?

Dental insurance plans vary, but most cover preventive services like cleanings and exams, as well as basic procedures such as fillings and extractions. Some plans also cover major procedures like crowns and root canals.

How does dental insurance work?

Patients typically pay a monthly premium for dental insurance coverage. When they receive dental care, the insurance company may cover a portion of the cost of some procedures, while the patient is responsible for paying the remaining balance. The insurance company then gives you a set benefit amount that is drawn from to pay the provider for services rendered. Once that benefit amount has been used, any additional services are solely the patient’s responsibility and will not be covered by insurance. Covered procedures, benefit amounts, amounts paid by insurance, and
percentages covered will vary from insurance company to insurance company and may vary from year to year with the same insurance company.

Does dental insurance cover cosmetic procedures?

Dental insurance usually does not cover purely cosmetic procedures like teeth whitening or veneers. However, some plans may cover cosmetic procedures if they are deemed medically necessary due to decay, tooth loss, etc.

Are there different types of dental insurance plans?

Yes, there are various types of dental insurance plans, including Preferred Provider Organization (PPO) plans, Health Maintenance Organization (HMO) plans, and dental discount plans. Each type has its own network of dentists and coverage options. Contact your dental insurance carrier to get a list of dental providers that are in-network.

Can I choose my own dentist with dental insurance?

Depending on the type of plan you have, you may be able to choose your own dentist, or you may be required to see a dentist within the plan's network. It's important to check your plan details to understand your options. You may also have the option to see a provider that is out-of-network, but your insurance may pay at a reduced rate.

How can I find out if a specific procedure is covered by my dental insurance?

You can review your dental insurance plan documents or contact your insurance provider directly to inquire about coverage for specific procedures. Christensen Dental can also help verify coverage and provide cost estimates.

What should I do if my dental insurance claim is denied?

If your dental insurance claim is denied, you can appeal the decision by providing additional documentation or requesting a review of the claim. Christensen Dental can assist you with the appeals process.

Does dental insurance have a waiting period?

Some dental insurance plans have waiting periods before certain services are covered. This means that you may need to wait for a specified period of time after enrolling in the plan before you can receive coverage for certain procedures.

What happens if I don't have dental insurance?

If you don't have dental insurance, you will be responsible for paying the full cost of dental care out of pocket. Christensen Dental offers flexible payment options and may be able to help you find alternative financing solutions.

What is a missing tooth clause?

A missing tooth clause is a provision often found in dental insurance policies. Essentially, it outlines specific conditions under which the insurance will cover the replacement of a tooth that is already missing at the time the policy is taken out. Typically, this clause specifies that the insurance will not cover the replacement of teeth that were missing before the policy's effective date. If you're missing a tooth when you sign up for dental insurance, the insurance might not cover the cost of replacing that tooth because it was already missing before you had coverage. This is important for policyholders to understand so they can manage their expectations regarding coverage for dental procedures involving missing teeth.

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