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Understanding Your Dental Insurance

We know figuring out your dental insurance can be a headache, and we want to help you make the most of your investment. That’s why we have put together an FAQ -- to help you understand just how dental insurance works. Because when it comes to maximizing your benefits, knowledge is power. Take some time to read the information below, and feel free to give us a call to discuss any remaining doubts.

Q: What is the difference between in-network and out-of-network?

A: Dental insurance works much like your medical insurance. A dentist who is in-network with your dental insurance has come to an agreement with the company to provide certain services to you at a discounted rate. The dentist will be reimbursed by the dental insurance company after services are provided. A dentist who is out-of-network has not come to an agreement with the insurance company and therefore is not obligated to provide discounted services.

Q: Can I still receive coverage from an out-of-network dentist?

A: Even if a dentist is out-of-network with your dental insurance provider, that doesn’t mean you can’t still receive discounted care. PPO (preferred provider organization) plans allow greater flexibility in who provides your services, meaning you can choose your own dentist or doctor. At the office of Daniel S. Fox, DDS, we are in-network with a number of providers. And we are also happy to file insurance claims for every provider, in-network or out-of-network.

Even if you don’t see your insurance provider on your dentist’s in-network plans, go ahead and contact the dentist’s office to discuss how you can receive your discounts, anyway.

Q: What services am I eligible for under my plan?

A: Preventive dental care is the foundation of every healthy smile. To reduce the risk that you will need expensive, complex treatments later on, your dental insurance company should completely cover two checkups and cleanings every year. Most provide an annual set of x-rays, too. You should also receive partial or complete coverage on restorative treatments and possibly even orthodontics or select cosmetic services.

To fully understand your dental insurance coverage, get in touch with your provider. Prepare a list of questions beforehand. If you are covered under your employer, you can also find this information through your human resources department.

Q: Do my benefits expire?

A: Most dental insurance plans run on a calendar year, meaning that your plan will renew every January 1. If you have met your deductible but not reached your annual maximum (the highest amount your dental insurance will pay for services), you must say goodbye to those benefits and meet your deductible all over again for the new year. Make sure you are maximizing your dental insurance by finding out what services you are eligible for annually -- like a checkup and cleaning every six months -- and taking advantage of them within the calendar year. 

Q: How does dental insurance work at Daniel S. Fox, DDS?

A: We want to make paying for dental care a breeze, and so we are happy to be in-network with a number of dental insurance plans. And even if we are not in-network with yours, we will gladly file any dental insurance paperwork. We are also happy to offer our in-house dental savings plan for people without dental insurance. Please get in touch with our office to find out the specifics of affordable dental care!

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