What do you really know about dental insurance? As it may be a foggy topic depending on your situation, patients often wonder: how much will the procedure cost? What does my insurance cover?Â
Whether or not youâre comfortable with the terminology of medical insurance, itâs always good to know which procedures your dental insurance covers fully. If your procedure isn’t fully covered, we’ll help you find out how much youâll have to pay.
Firstly, dental insurances are like any other insurance: you choose a contract type, and pay for it annually or monthly. Then, the insurance plan that youâve chosen will condition the allowed charge accordingly. More specifically, the allowed charge is the amount your plan will pay for each procedure. In fact, you will benefit from your insurance plan from the effective date, when you become eligible.
First of all, letâs say it: at Lasry Dental Clinic, we take most major insurances. Moreover, we aim to provide you with great dental care, whatever medical insurance you may have. To clarify, we will provide you care and treatment even if you donât have one.
In other words, our role, as a dental office that takes medical insurance, is to offer you the best treatment. Most importantly, we look out for you by checking your gums, teeth and general oral health. Indeed, at Lasry Dental Clinic, we focus on what your needs are to keep a healthy and glowing smile. Therefore, our treatment recommendations only depend on what is best for you.
As a matter of fact, Dr Samuel Lasry is a PPO plan dentist. As a PPO in-network care provider, we have agreed specific pre-negotiated rates on determined dental procedures and treatment, for all PPO plan members.
Do you accept my insurance?
First of all, we accept all PPO dental insurance. We also accept direct payment and can provide details of financing options such as AlphaeonÂź Credit and CareCreditÂź. Donât let confusion about dental insurance prevent you from seeking treatment, get in touch with our office today.
Will my new insurance cover my dental expenses?
Most insurances have a waiting period. In other words, itâs a specific time an insured has to wait before their coverage kicks in. The dental insurances’ waiting period is often 6 to 12 months. As the policy holder, you need to consider your ability to pay for your dental expenses during this time lapse.
Whatâs a "missing tooth clause"?
Many insurances have a special clause called the âmissing tooth clauseâ. Consequently, it stipulates that if you have a missing tooth when contracting your insurance, they will not cover any expenses related to the treatments you may receive.
Is Invisalign covered by insurance?
This will depend on your insurance coverage. While some plans only cover orthodontics for teens, other do so for adults too. In this instance, you would need to self-finance your orthodontic treatment. We offer flexible payment plans to help make Invisalign treatment affordable and accessible to everyone.
In most cases, as a patient, you will pay a certain amount for a treatment, care or procedure. Then, afterwards, the insurance will pay you back a certain amount. This determined amount is called the deductible. For instance, some dental insurances have restrictions towards the number or frequency of certain specific treatments. In fact, this is often the case for composite bondings or implants.
At Lasry Dental Clinic, we can help you find out your deductible by contacting your dental insurance. Above all, don’t let confusion about dental insurance prevent you from seeking treatment, get in touch with our office today !
While each insurance contract is different, there are similarities in what you can expect from your dental insurance. Typically, most medical insurances pay for 100% towards cleanings and preventive dental care. Likewise, they often pay for 80% regarding basic care such as fillings, whereas they might pay for 50% of the costs for major work like crowns.
Furthermore, we can also provide you help in getting some dental work done that you may not think you could have! That is to say, we advise you by looking up what your dental insurance covers.
PPO/PDP
-for Preferred Provider Organization.
PPO plans contract with medical practitioners (doctors and hospitals) to create a network of participating providers. That is to say, you pay less when visiting the in-network partners, but you can also visit providers outside of the network with an additional cost.
DMO
-for Dental Maintenance Organization.
This plan is a dental version of HMO (Health Maintenance Organization) plans, as a patient youâre assigned to a dental office and cannot visit any other dental office.
EPO
-for Exclusive Provider Organization.
This recent type of insurance is a hybrid type, between PPO and DMO. If this is the type of insurance you have, you can go to any office thatâs part of a PPO meaning you can visit any in-network care provider, but you canât go to any practitioner outside the network.
Indemnity plans
If you’re a policy holder of this type of medical or dental insurance, you can visit any doctor or hospital, and the insurance will pay for a percentage of the bill. This percentage is based on a reasonable and customary fee. For example, you can go to any practitioner, you don’t have to check if they’re in-network or not.
Union plans
These plans are very specific depending on your area. Usually, a lot of union plans pay in full.
Medicaid plans
Likewise, these plans also vary from state to state. This insurance program is designed to offer free or low-cost health coverage to low-income people, elderly, pregnant women and people with disabilities. To know if you can benefit from a Medicaid plan, you need to put in an application. If you qualify, your health coverage can begin immediately, whatever the time of year.
ACA plans
-for Affordable Care Act, also known as Obamacare.
These plans are most often contracted on your own, and not through your employer like most medical insurances.
We take all PPO dental insurance. Inquire about individual coverage options such as Aflac or financing options such AlphaeonÂź Credit and CareCreditÂź
