Patients are often confused about their dental benefits and how they work. It is important for patients to understand that the dental insurance dollar amount that a patient receives is based on what the employer has chosen for his/her employees. That is, the more the employer pays into the benefit, the more the insurance will reimburse the dentist or patient.
There exists no dental insurance to our knowledge that will cover all of the costs for a patient. Some pay on a fixed dollar amount, while others pay on a percentage basis. We have often found that patients will call our office telling us that the insurance will cover 80% of their treatments, but in reality, the plan only pays 80% of a preset fee schedule, which reflects fees much lower than what is commonly found in a high quality private practice. Other limitations that are found with dental insurances are the annual maximums, which unfortunately have not changed in almost 40 years.