Do You Take My Insurance?
YES – We Probably Do!
This must be one of the most common questions we receive, and the answer is most likely Yes You Can! We submit insurance claims to nearly every dental insurance plan, including nearly all PPO insurance plans. Also, we have patients that come to us who have all kinds of insurance plans!
But Hold On!
However, even though we “take your insurance," we may not be “in network” with your specific insurance plan. How does that work? Many patients are surprised to learn that nearly every dental insurance plan has "out of network" benefits." We have many patients that come to us "out of network" every day from all of the major dental insurance companies like Delta Dental, MetLife, Humana, Aetna and many others (see below). More than likely, we have patients who have your same dental insurance plan who come to our office even though our office is “out of network” and it seems to be working out well for them.
It is true that a very small percentage of dental plans are “closed panel” plans which means the patient must absolutely go to one of their in-network providers, to get any reimbursement, but they are not very common. In fact, a key question to ask your insurance company when selecting a dental plan or finding a provider is - does my plan have "out of network benefits?" The answer will probably be “yes, but you will probably have to pay a bit more to go "out of network.” What does that mean?.
Will I pay More If I Come To Your Office as an “Out of Network" Patient?
The answer to this question is: Maybe or Maybe not. Nearly all of our our patients who come to us "out of network" who have "out of network benefits" in their plan, do not pay any more out-of-pocket costs for preventative services than if they went to a dentist in their specific network. For those that do have to pay something extra t is usually less than $10 per visit. It’s true!
When dental procedures are needed, you may pay more to be seen in our office, than by an "in network provider" but usually not very much. From our experience, out of network patients will pay on average of somewhere between 0 – 20% more on dental procedures in our office than at an in network office. However, do our best to estimate the portion the insurance will not pay before the procedure is performed so you can make a good decision beforehand. We can also give you a list of the procedure codes to give to your insurance company to find out exactly what the insurance company will or will not pay, if that is important to you. We can often do that leg work for you as well if you like! We always do our best to provide you with this information in advance so you can make your own decision. This seems to work out well for our many of our patients who come to us "out of network."
Our goal is to minimize any financial surprises you may encounter as we move forward with your needed dental treatment. While we do our best in this area, some insurance plans are particularly difficult to work with and we try to let you know that in advance as well.
Our philosophy –
Our Philosophy is to always recommend the highest quality care to our patients regardless of insurance limitations. We understand that different patients have different oral health objectives. We understand that insurance considerations are important for many patients. We are respectful with financial limitations and always provide alternative treatments to help patients make the best decision for themselves in their unique situation.