Letting Your Insurance Dictate Your Dental Needs
By S.S. Dental Assistant
July 10, 2018
Category: Uncategorized
Tags: benefits   insurance   treatment  



$1 doesn’t buy you much these days, but neither does your average dental plan.  Look at insurance as a “coupon or a discount” because that’s really what it turns out to be.  No dental plan is set up to cover ALL of your dental costs.  The average annual dental insurance policies generally limit coverage to $1000-1500 per year. Unfortunately dental maximums have generally not increased for about forty years.

The dental office’s goal is to help take good care of your teeth.  It is tempting to only do what is “covered by insurance”, but less is not always best.  Your dental coverage is not based on what you need or what your dentist recommends.  It is based on what you (as individuals) or your employer chooses to pay into the plan.

Many dental carriers refer to their allowed payments as UCR, which stands for usual, customary and reasonable.  UCR is a listing of payments for all covered procedures negotiated by your employer and the insurance company.  When you receive and EOB (explanation of benefits) stating that your dental bill exceeded the UCR, it does not mean that your dentist charged too much.  It means that the negotiated amount will be paid toward your treatment, and that the rest “exceeds” that amount. 

Scenarios for thought:

  • If you hit a deer with your vehicle and your auto insurance didn’t cover it in full, would you fix it?

  • If you have a recommended medical procedure not covered at 100%, would you still have it done?

  • Tires are not a covered item under insurance, but you’ll still replace those tires once they are worn.

Remember, that your dentist’s responsibility is to prescribe what is best for you.  It is a mistake to let insurance benefits be your primary consideration when you make decisions about dental treatment. 




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