Why Does My Dental Plan Cover Only Some of the Treatments the Dentist Recommended?

Patients and friends of our practice wonder why their dental insurance does not cover 100% of their treatment, or in some cases the entire treatment at all. Dental insurance is a valuable part of our health benefits, but its purpose over time has become a tool to lessen the cost of dental treatments.

Unlike medical insurance, dental insurance plans are designed to prevent
the dire and catastrophic dental situations through ongoing prevention. Routine exams, hygiene appointments, radiographs and fluoride treatments are more likely to be covered at a higher percentage as compared to restorative treatments such as composite fillings, crowns, root canals, and implants. Insurance plans tend to reduce their percentage of coverage on major procedures quite routinely, or will not cover the procedure entirely. Unfortunately, this notion of coverage, leaves individuals mistaking their insurance plan’s “covered procedures” as what would be the best treatment choice for their oral health.

At our office we provide careful examinations and build a treatment plan that is custom to your needs and interests. This plan is built with your dental goals and an ideal oral health model in mind. Once we form this plan together, we will work with your insurance company to help you receive the maximum benefits that you can annually, so your insurance does work for you.

There are great advantages to living by the rule of prevention. Typically seeing a dentist for regular routine exams can prevent greater future costs, time in the dental chair, and pain. Fortunately, preventative services are well covered by many dental plans. I think taking advantage of the preventative services your insurance plan offers will save you money in the future, and keep you smiling longer.