INSURANCE PLANS ACCEPTED
Insurance information is one of the more frequently asked questions by our patients. We understand if you are hesitant or unsure of your insurance eligibility.
Most insurance plans are accepted by our office.
As a new patient, it may be helpful for you to know that most insurance plans typically cover 100% of new patient dental exam, x-ray imaging, diagnosis and preventative cleaning (at least twice a year).
To help you understand the basics of how dental insurance coverage typically works, let's look at a typical example below:
Let's say John Smart is a recent college graduate who started working for a local IT company (Acme Tech Toys!) two months ago. Recently, John has started experiencing some pain in his upper right molar tooth. John schedules an appointment with us for a check-up.
During his first visit, John provided his dental insurance information (for TeethCare Insurance Dental Plan) by handing over his insurance card to the office staff. Our office staff called the customer service for TeethCare Insurance to obtain the insurance benefit profile for the patient. In our example, we found that John's insurance plans provides a maximum benefit of $2,500 per year. Also, as part of the insurance benefit, John is entitled for preventative care, including bi-annual exams, new patient full-mouth x-ray and preventative cleaning for a full 100%.
After the doctor examines John's teeth, we formulated a treatment plan for him. As it turned out, John needed to have a four-quadrant scaling root planning ("full-mouth deep cleaning") performed. For molar tooth, John needed a root canal treatment, build-up and crown. And as part of the exam, the doctor also detected a cavity in tooth #19 which required a filling.
- John's insurance plan covered 100% for preventative (which included the new patient exam, full-mouth x-ray and preventative cleaning).
- For the cavity and the root-canal treatment, his plan covered 85% of the costs (after a one-time $25 annual deductible for any treatment besides preventative).
- And for the build-up and crown (since these are typically considered "major treatments"), John's insurance covered 50% of the costs.
Insurance plans and coverage will of course vary and as such, we encourage patients to reach out to their insurance company directly to learn more about their insurance benefits. At the same time, our office staff is also always available to assist if needed.