Question 1

How can we help make dentistry more affordable?

Accepted Answer

Any of our Lincoln, NE dental clinics offer affordable family dentistry and on top of that, we will provide and send claims to your insurance carrier. Dental insurance is meant to cover some, but not all, of the cost of dental treatment. Your insurance includes coinsurance provisions, deductibles, and certain other expenses that must be paid by you at the time of service. Based on the information from your insurance we can give you an ESTIMATE of the total cost for the services, however, this is an estimate only. Subsequently, if there is any remaining balance after your insurance pays, this becomes your responsibility.

Question 2

Why doesn’t my insurance cover all the costs for my dental treatment?

Accepted Answer

Dental insurance isn’t really insurance (a payment to cover the cost of a loss) at all. Dental insurance is actually a money benefit typically provided by an employer to help their employees pay for routine dental treatment. The employer buys a plan based on the amount of the benefit and how much the premium costs per month. Most benefit plans are only designed to cover a portion of the total cost.

Question 3

But my plan says that my exams and certain procedures are covered at 100%.

Accepted Answer

Coverage at 100% is usually what the insurance carrier allows as payment toward the procedure, not what your dentist or any other dentist in your area may actually charge. For example: your dentist might charge $80.00 for an examination (not including x‐rays), your insurance might allow $60.00, if they pay $60.00 that is 100% coverage. You, however, must still cover the $20.00 difference to satisfy the entire charge of $80.00.

Question 4

How does my insurance carrier come up with their allowed payments?

Accepted Answer

Many carriers refer to their allowed payments as UCR, which stands for usual, customary and reasonable. However, usual, customary and reasonable does not really mean what you might think it does. UCR is a listing of payments for all covered procedures negotiated by your employer and the insurance company. This listing pertains to the cost of the premiums and where you are located in your city and state. Your employer has likely selected and allowed payment or UCR payment that corresponds to the premium cost they desire. UCR payments could be accurately called negotiated payments.

Question 5

Since most payments are negotiated, does this mean that there is always a balance left for me to pay?

Accepted Answer

Typically there is always a portion that your benefit plan will not cover.

Question 6

I received an Explanation of Benefits from my insurance carrier that says my dental bill exceeded the usual and customary. Does this mean that my dentist is charging more than he or she should?

Accepted Answer

It does not mean that your dentist is charging too much. Remember that what insurance carriers call UCR is really just what your employer and the insurance company have negotiated as the amount that will be paid toward your treatment. It is usually much less than what any dentist in your area might actually charge for a dental procedure.

Question 7

Why is there an annual maximum on my benefits?

Accepted Answer

Maximums limit what a carrier has to cover each year. Amazingly, despite the fact that costs have steadily increased, annual maximum levels for dental care not changed since the 1960’s.

Question 8

Why do some benefit plans require me to select a dentist from a list?

Accepted Answer

Usually a dentist on the list has agreed to a contract with the benefit plan. These contracts have restrictions and requirements. If you choose a dentist on the list, you typically pay less toward your dental care than if you choose a dentist not on the list. If your dentist is not on the list this does not mean that something is wrong with the dentist or a particular dental office.

Question 9

Why does my dental plan only pay toward the least expensive alternative treatment?

Accepted Answer

To save money. If your dentist recommends a crown, but your insurance only offers benefits toward a filling, this does not mean that a filling is all that can be done or that a filling is the best option. In short, it just means you’ll need to pay a little more should you choose a crown. Remember your dentist’s responsibility is to prescribe what’s best and the insurance carrier’s responsibility is to control payments. If you, like many others, prefer to go a different route than your insurance company will pay for, inquire about dental payment plans with a dentist near me in Lincoln, NE. Dental payment plans are an excellent option for allowing you to get the treatment you need.

Question 10

What should I do if my insurance does not pay for treatment I think should be covered?

Accepted Answer

Because your insurance coverage is between you, your employer and the insurance carrier, your dentist does not have the power to make your plan pay. If your insurance does not pay, you are responsible for the total cost of treatment. The Employee Benefits Coordinator at your place of employment may also be able to help. Complaints can be lodged with the state Insurance Commission.

Question 11

What if my spouse has insurance?

Accepted Answer

Oftentimes you will get little or no coverage from a second plan.

Question 12

Why can you only estimate my coverage?

Accepted Answer

Dentists deal with thousands of plans and hundreds of types of treatments each year. Most carriers refuse to release the details of their plans and many times change policies and reimbursements amounts without notice.

Dental payment plans and Understanding your dental insurance

Dental Payment Plans Could be Your Answer to Affording Necessary Dental Treatment.

EXPLORE AFFORDABLE DENTISTRY NEAR ME AND OUR PAYMENT OPTIONS

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