Dental Insurance Myths: What you need to know

Trying to decipher the nuances of different dental insurance plans can be difficult. There a so many carriers and then there are different plans within those carriers that it can be overwhelming. Our goal today is to look at some of the common myths of dental insurance and what you actually need to know.

Myth: The insurance company will pay the fees that the dentist charges.

Fact: It has been the experience of many dentists that some insurance companies tell their customers that “fees are above the usual customary rate” instead of telling them that the “insurance benefits are low.” A good thing to remember is that you get back only what your employer puts in minus the profits of the insurance company.

Myth: The new alternative insurance plans are the same as the traditional plans.

Fact: The new plans referred to as PPO’s or DMO’s are simply discount plans. All these type of plans require the dentist to severely discount their fees nearly 50%. In order to take these plans and remain profitable business, the dentist must choose less expensive or faster options that may not provide the same long term results as when they are not restricted by the insurance company.

Myth: Once you reach your yearly deductible, everything else is free.

Fact: Dental insurance does not act the same way as medical insurance. It acts more like a coupon. It typically does not pay for the entire product or service and only pays a vague percentage. And once you have reached your yearly maximum, it no longer pays on anything.

Myth: The insurance will pay for the dental work because I need it.

Fact: Not all procedures that are needed will always be covered by your policy. When your company selects a plan, it is decided which procedures may or may not be covered. The lack of coverage by your insurance company does not mean it is not needed, it just means your plan has chosen not to cover the procedure.

All of this can obviously be very confusing and even frustrating. If you have questions or concerns on which dental plan may be best for you and your family, please feel free to contact us and we can hopefully help you in deciding which one is best for you.