We are committed to continuously improving access to our goods and services by individuals with disabilities. This website is currently being updated to enhance the usability and experience for persons with disabilities. If you are unable to use any aspect of this website because of a disability, please call 9784704555 and we will provide you with prompt personalized assistance.

Blog

A Breakdown of Dental Insurance

Posted by: Dr. Sirakian     Categories: Uncategorized

Why doesn’t my dental insurance pay for this? This is a frequently asked question when it comes to dental coverage. It is common for patients to be unsure of what their coverage actually covers and why they have certain limitations.

Dental insurance can be very confusing, so, here are a few basics to help you better understand dental insurance.

UCR (Usual, Customary, and Reasonable)

There are different dental insurance plans that you might have. One plan is the UCR plan. UCR stands for, usual, customary, and reasonable. This means a couple of different things for your coverage.

Under a UCR plan, patients get to pick which dentist they see and the plan pays for an established percentage of the dentist’s fee or they pay the plan sponsor’s “customary” or “reasonable” fee limit. These plans do not necessarily reflect the prices of dental procedures. Often times the limits in place do not take into account the price of dentistry in that area or region. Dental insurance companies do not have any regulations on reimbursement levels, which means that there is a lot of room for fluctuations.

Annual Maximums

Whoever provides your plan for you, whether it is through your job or a private company, they are the ones who set the annual maximums. Annual maximums are the final set of reimbursement that is part of your plan. That number is how much your insurance will cover.

Preferred Providers

Another thing to keep in mind when it comes to dental insurance is that some insurance plans will request that you pick a dentist from their list of preferred providers. This usually means that if your previous or current dentist is not on the list, then you will have to switch to a different dentist.

Least Expensive Alternative

Dental insurance also has something called, “least expensive alternative treatment.” This phrase means that, your plan may not offer any coverage for expensive treatments or procedures, but they will cover the least expensive alternative. It may not be the best option for your oral health, but the cheaper option is what they will cover. It is best to discuss with your dentist the best option for you.

Preexisting Conditions

Some dental insurance plans may not cover any preexisting conditions that you had previous to joining that plan. This can be difficult because they may still require treatment. Try to find a plan that allows you to still receive treatment for a preexisting condition or talk to your dentist about what other options you have.

Treatment Exclusions

Your dentist might recommend a preventative treatment, like sealants, and your insurance may not cover it. While these sorts of procedures can save you money in the long run, your insurance may not cover them because they are not necessary. The same may go for certain procedures that your insurance does not deem as necessary.

Dental insurance can be confusing, tricky, and hard to understand. So, we decided to provide you with a breakdown of dental insurance to make your experience easier and stress-free. Check out our blog post to learn more.

Source

Mar
31

How Can A Plaque-Identifying Toothpaste Prevent Heart Attacks or Strokes?

While fluoride is essential for creating a healthy, thick enamel layer on teeth, if too much of it is present, especially at a key point in a child’s dental development, a condition called fluorosis can occur. This condition presents itself most commonly in children as old as nine in the form of discoloration of teeth, […]

Mar
20

Everything in Moderation (Including Fluoride)

While fluoride is essential for creating a healthy, thick enamel layer on teeth, if too much of it is present, especially at a key point in a child’s dental development, a condition called fluorosis can occur. This condition presents itself most commonly in children as old as nine in the form of discoloration of teeth, […]

Mar
9

Factors that determine the cost of dental implant treatment

One of the first questions that patients looking to replace missing teeth with dental implants ask is, “How much do dental implants cost?”. The inevitable answer is, “It depends”. This isn’t because the person answering the phone is trying to brush off the question, it’s because it really does depend. Here are some factors that […]

Mar
4

Tooth Growing in Nose?

Say you’re at the doctor’s office because of a stuffy, drippy nose that just won’t go away. The last thing you’re probably expecting to hear is that there is a tooth growing inside your nose. Yes — you read that right. According to an article from Live Science, a man received a surprising diagnosis after […]

Feb
26

3 Ways Popcorn Can Ruin Your Mouth

How many times have you bitten into an under-popped popcorn kernel and felt it clash violently with your teeth. For a split second you worry that the kernel actually damaged the tooth and you swear you’ll never eat popcorn again. But then you realize that you’re fine and continue eating popcorn. But each time you […]

69 Park Street, Andover, MA 01810
| |
Fax: 978.470.8844
|
X
  • Call 978.470.4555 or fill out the form below.

X
[contact-form-7 id="244" title="Request Appointment"]
X

The information presented here is not intended or implied to be medical advice, diagnosis, or treatment. It should be used for informational purposes only.

[contact-form-7 id="1341" title="A04 Appointment"]
Book an Appointment
To book an appointment please feel free to call us at 978.737.7060 or complete the form below.

Step 1 of 2

50%
-

Terms and Conditions

Here at Sirakian Aesthetic & Implant Dentistry, we work diligently to protect our patient's rights and privacy. Requesting an appointment via our Internet portal is considered part of what HIPAA has identified as electronically protected information (ePHI). Unfortunately, despite the best efforts we make or take, there are people or entities that may attempt to intercept the data you transmit to us. By checking the box, and electronically making an appointment, you understand that you are making an appointment over the internet and that Sirakian Aesthetic & Implant Dentistry will keep this information confidential but cannot guarantee that others, outside of our practice, may not illegally intercept this communication. As a result of continuing, you are sending this transmission and accepting the inherent risk(s) associated with making this request for an appointment. As an alternative, you are always welcome to contact our office via telephone to schedule your appointment.