Dental Insurance Information
The coverage provided by dental insurance varies widely between plans. In most cases, your employer will offer one or more plans. The contract established between your employer and insurance provider determines the type of coverage available to you. Dental insurance can be incredibly complex. Figuring out what your insurance plan actually covers can seem overwhelming and is often frustrating, but with help from our staff we can give you a better insight into your insurance plan.
A Variety of
There are many providers of dental insurance, all of which offer different levels of coverage. Midwest Oral Maxillofacial & Implant Surgery accepts all of the following insurance plans among many others.
How Dental Insurance Works
By purchasing a dental insurance plan, you enter into a contract with the company. They agree to pay certain amounts for certain procedures and you assume responsibility for what they do not cover. Generally, the terms of your coverage are spelled out in the contract. Different plans approach coverage in different ways. Some require you to reach a deductible before paying anything, while others pay a percentage immediately. Understanding the different terms associated with your insurance plan can help you figure out your coverage.
A deductible is a minimum amount of money you need to pay towards dental care before your plan coverage starts. Most plans do not require a deductible for diagnostic or preventive services.
Many plans have a cap on how much money they will pay for any given treatment during the year. Anything over that amount becomes your responsibility. For example, if your plan has a annual maximum of $2,000 and your dental expenses exceed $3,000, you have to pay the additional $1,000. In some cases, you can raise your annual maximum to better suit your needs. There is usually a separate lifetime maximum for orthodontics.
Least Expensive Alternative Treatment (LEAT)
If your plan has a LEAT clause, the company will only pay for the least expensive treatment available for any given condition.
Some plans have limitations on when they will begin paying for certain complex procedures. For example, many insurance policies will not pay for major procedures until the plan has been in effect for more than 12 months.
Understanding Your Benefits
If you are confused about your coverage, you can ask out staff to help you or call your insurance provider directly. You can also ask your provider for an Explanation of Benefits (EOB) which lists the procedures your plan does and does not cover.
Making the Right Choice for You
When deciding whether to undergo a certain dental treatment, it is important to consider more than your insurance coverage. The least expensive treatment option may not be the right one for you. Be sure to discuss all aspects of your coverage and treatment plan with your dentist and oral surgeon before making a decision.
We have 6 locations in the
greater St. Louis area ~
Chesterfield, South County, Festus
St. Peters, O’Fallon, Wentzville
Great care! If I ever have to do this again I’d return. The doctor was calm and kind, explained everything to me before hand and answered all my questions. The support staff was just as sweet. The office was clean and has COVID precautions in place.
— Clarice V.