At the Montgomery dentistry practice of Geoffrey A. Iverson, DDS, we truly care about creating a treatment environment where patients feel welcome and relaxed throughout their time in our office. One stressor that not every dental practice thinks of is dealing with the cost of dental care. Our team works with dental insurance providers every day, and we are able to maximize coverage and minimize out of pocket costs to help fit the costs of your treatment into your budget and take the stress of handling insurance claims off of your shoulders. If you want to learn more about dental insurance and billing options, keep reading or feel free to contact our Montgomery dentistry team to learn more or schedule an appointment with us.
Basics of Dental Benefits
There are two basic forms of dental insurance most patients utilize – health maintenance organization (HMO) plans and preferred provider organization (PPO) plans. HMO plans have lower premiums, but they place more restrictions on the dental offices you can visit and treatments you can receive. We are not currently in-network with any HMO policies. We are happy to work with patients who have PPO plans. These are more common, and they allow patients greater flexibility in choosing their dentist and treatment options. They do typically have higher monthly premiums. Every dental benefit plan represents a unique contract between the patient and their insurer, so before we offer coverage estimates, we’ll want to carefully review your individual policy. In most cases, insurance plans cover the following treatments:
- Preventive dentistry – including checkups, cleanings, dental sealants, and more receive 80 to 100% coverage
- Restorative dentistry – including fillings, dental crowns, dentures, and more receive 50 to 80% coverage
- Orthodontics (when elected) – including traditional braces and nontraditional options receive 20 to 70% coverage
Tips to Maximize Coverage
To make the most of your dental insurance benefits, you should keep the following tips in mind:
- Visit the dentist every six months for preventive checkups. This minimizes risk for advanced dental health issues that need complex treatments with less insurance coverage. Most insurers offer 80 to 100% coverage for biannual preventive dental exams and cleanings.
- Know your annual plan maximums and plan accordingly. Most insurers limit annual coverage to just $1000 to $1500 worth of coverage. If you need a complex treatment like braces, you can often plan to receive treatment spread over two or more plan years to make the most of your benefits and avoid exceeding plan maximums.
- Talk to your dental team about all of your options and how they’re covered by insurance.
- It’s always best to ask for preapproval or preauthorization from the insurer before beginning complex treatments to ensure your benefits are available and avoid unpleasant surprises on your bill.
In-Network VS Out of network Care
PPO dental benefit plans are created to be flexible, allowing patients to choose their dental care provider and treatment plan while still offering some coverage. However, in-network dentists may be more familiar with how a specific insurer covers treatments, and they often have agreements that limit the prices they charge for treatment to fall within a range considered fair by the insurer, which may reduce your out of pocket costs. Out of network dentists don’t necessarily know the insurer’s fair pricing, and they may charge higher fees for their services. You will be responsible for paying the difference in pricing, but these differences are typically negligible.
Our Financing Options
We do ask that patients be prepared to remit payment for the out of pocket percentage of their treatment costs, copayments, and/or deductible at the time service. We accept cash, checks, and major credit cards (American Express, Discover, MasterCard, and visa). For those patients paying in full on the day of treatment, we are happy to extend a 5% savings. If you need to spread the cost of care out over several small, monthly installments, we encourage you to apply online for financing through CareCredit. This third-party financier specializes in medical and dental financing, and most patients are eligible for low or no interest financing. Don’t hesitate to ask our team about CareCredit during your treatment planning. We’ll be happy to help you apply for financing.