Dental Insurance Plan: Covers and Benefits | FAQ - General Questions
Q. What does my insurance cover?
If I had a dollar for every time I have heard this question in the past 20 years I would have more than enough money for our office to be a FREE clinic! This question is sometimes also followed with “I only want to do what my insurance covers.” I certainly understand that financials are often a concern, but I also get the feeling that sometimes people judge whether they really need treatment based on what their insurance policy will or will not cover. This is entirely not true!
Sadly, your dental insurance coverage is not based on what is best for you. The coverage you receive is based on a contract between the insurance company and your employer.
The people who are looking out for you are us, your dental team! Farmington Village dentists, Dr. Nadeau and Dr. Krause, and hygienists Ashley and Donna are the ones who are seeing you. They are the ones who care about your dental health, and they make personalized recommendations based on your personal oral health needs.
The truth is, dental insurance is not great. Over the years I have watched it get worse and worse. In general, I have watched insurance cover less than it used to, have more restrictions than it used to, and actually lower their yearly maximums. One thing I also hope to help you understand is that your cleanings are not free. They are a part of your annual maximum just like anything else, and once that maximum is reached cleanings are no longer covered.
My best advice to everyone who is trying to navigate through the nuances of a dental plan is to get as much information as you can about the plan and try your best to understand it. Emily and I spend hours on the phone and on websites every day trying to find out plan specifics and we do this to try to eliminate any surprises to our patients. However, you’d be amazed at the times we receive incorrect information about your plan – directly from your insurance company!
Q. How do I learn all about my dental plan?
A great place to start is by reading about the proposed benefits at open enrollment. By doing this you can start to really understand what your insurance could possibly do for you. I have had many patients realize that they are paying more in premiums than they are receiving in dental benefits!
Also, as the customer of the insurance company, you can call at any time and ask as many questions as you want. The information you obtain is often much more detailed and thorough than anything we can find out on your behalf. You are your own best advocate, and you have every right to ask your insurance company questions about the policy you are paying for. We hope that the more you understand your plan the better your ability will be to make informed decisions about your dental health.
Finally, here’s an interesting article about the head of an insurance company. Have you ever wondered why your premiums are so high and your maximum is so low? Have you ever wondered why your insurance denies claims when it should have paid them? Perhaps it’s to pay the outrageous salary of its CEO?
To summarize:
- Your insurance benefits details are more available to you than they are to anyone in our office, so by calling and asking your own questions you will get much more information.
- Be honest about the relationship you want with your dental provider. Is quality of care your priority or is what insurance dictates your priority?
- We are here to help, so ask any questions you may have.
- BE PROACTIVE – don’t wait until a claim is denied to learn what is and is not covered by your plan.
- Be proud you belong to a dental practice that won’t cave to the pressures of insurance and will continue to treat each individual to the best of our abilities.
Are you looking for a family dentist in the Farmington, CT area? We are happily accepting new patients and are here to help. Contact us to schedule your appointment today. We look forward to seeing you!
