Understanding the ins and outs of dental insurance coverage can be a confusing and frustrating endeavor. Between deductibles, annual maximums, limitations, exclusions, and trying to understand both dental terminology and insurance terminology, making sense of it all can feel impossible! At Smith Family Dental, your Hillsboro OR dentist, we're experts at navigating tricky insurance policies and are happy to answer your questions!
What Does My Insurance Cover?
The most common questions we get are whether your insurance will cover a specific procedure and how much your portion of the total cost will be. Dental insurance coverage varies wildly from policy to policy, so it's impossible to give a definitive answer without examining your individual or group policy. In most cases, we can provide you with an estimate of how much your insurance will pay and how much you will probably owe before we schedule the procedure.
Most dental insurance policies cover preventative care, including routine examinations, cleanings, and X-rays. Some plans do limit the number of covered exams, cleanings, and X-rays allowed annually; if this is the case for your plan, we can let you know. You may have to pay part of the cost (coinsurance/copay), or it may be covered in full. If you have a deductible that you still need to meet all or part of, we'll let you know to minimize unwelcome surprises when the bill comes.
How Much Do I Have to Pay?
Basic and major dental procedures are covered at different rates depending on your coverage. There can be additional requirements to qualify for insurance payments, such as waiting times before major procedures are covered and pre-authorizations. We'll submit your pre-authorizations for you and let you know if a specific procedure is likely to be covered based on your policy.
Will My Insurance Cover Cosmetic Dentistry?
If you have cosmetic dental issues you would like to address, we can check your insurance plan to see if the treatment you want may be covered, but most insurance policies do not cover cosmetic dentistry. Orthodontics may be covered in your policy, or it may require a separate orthodontic coverage, or it may not be available.
What If I Don’t Have Dental Insurance?
If you are uninsured, underinsured, or are simply interested in additional savings, Smith Family Dental also offers the Quality Dental Plan! This in-house dental savings plan is designed to reduce your out-of-pocket expense for all of your dental care.
With membership in the Quality Dental Plan you'll receive 100% coverage on preventative care such as exams, cleanings, and X-rays. In addition, the Quality Dental Plan offers a discounted rate on crowns, implants, bridges – even cosmetic surgery! Our office will happily help you enroll in the Quality Dental Plan and start saving you money on all your dental needs today.
Have More Questions? Call Us!
If you're still confused about your coverage or have other questions about your insurance plan and what it will cover, the best way to get your questions answered is to contact us directly.
Our Hillsboro, OR dental office staff has years of experience dealing with insurance companies on your behalf. Call and schedule your appointment today and we'll navigate the maze of insurance so you don't have to!