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Understanding Dental Insurance

portrait of a familyWe understand that dental insurance is an important investment for many of our patients. That’s why your dentist, Dr. Terry O’Keefe, works with a number of dental insurance providers to help ensure you receive the maximum benefits you are eligible for. To find out whether or not we are in-network with your specific provider, please do not hesitate to get in touch with your office to learn more.

We are in network with the following providers:

Dental Insurance: The FAQ

Many patients have questions about how exactly their dental insurance works. To help, we have put together a list of frequently asked questions. Is yours not listed here? Don’t forget that we are just a phone call away!

Q: Do I have to visit an in-network dentist?

Dental insurance differs from your medical insurance a bit in that you do not necessarily pay more out of pocket when visiting a dentist who is not in your network. Even if we are not specifically in-network with your provider, we will file, process, and follow-up on your dental insurance claims to ensure you can stretch your insurance benefits as far as possible.

Q: What is an annual maximum?

Your annual maximum is the amount of money up to which your dental insurance is obligated to pay after you meet your annual deductible (more on that in a second). On the years that you meet your deductible, it is important that you get as close to the annual maximum as possible to avoid throwing away valuable benefits. Most insurance benefits do not roll over from year to year.

Q: What is a deductible?

The deductible is the amount of money you have to pay out of pocket before your insurance will kick in. Preventive services are usually 100% covered, but they may count toward your annual maximum. Our team can help you plan your treatments from year to year to make the most out of your investment.

Q: What is covered by dental insurance?

As previously stated, preventive treatments are usually fully covered. If you need a treatment like a tooth colored filling, a dental crown, or similar restorative care, it will probably be covered from 80% to 50%. Orthodontic treatment may receive partial coverage.

Q: Can you verify my benefits?

We happily work with you and your dental insurance plan, and that includes by performing a verification of benefits to find out just what you are eligible for. It’s a step that involves calling your dental insurance provider to confirm your coverage, as well as other details like how far you have left to reach your annual maximum.

Q: Is cosmetic dentistry covered by my plan?

Elective procedures are usually not covered by dental insurance, and that includes cosmetic dentistry treatments like porcelain veneers or professional teeth whitening. However, there may be some cases that certain treatments could be covered if they are necessary for your oral health. It’s always better to ask, so don’t hesitate to talk to us about the specifics of your coverage!