Will my Insurance Pay for all this Treatment?

This is a question that is often asked. Unfortunately no two insurances are the same. Each has different deductibles, co payments, maximums, inclusion and exclusions.

Some of the terms you should be made of aware of in your policy is:

  1. Pre-existing condition prior to coverage date. What this means is that some policies will NOT pay for the replacement of a tooth that was removed prior to being on their policy.
  2. Prior date of service. What this means is lets say you had a crown done 3 years ago by another dentist, and for some reason it fails. Most contracts will NOT pay for a new replacement unless its at least 5 years old (some policies even go 10 years)
  3. Alternative treatment. I love this one. Basically, your policy will only pay towards the least expensive available treatment. Lets say you are missing a molar on the lower left, and another molar on the lower right. The 3 conventional options to replace those teeth are an implant, a 3 unit fixed bridge onneach side, or a removable partial bridge/denture. Your insurance can opt for the partial bridge that is removable, leaving you with a very substantial copayment should you decide you do not want anything that’s removable.

In our office, we send documentation with your insurance for a predetermination. Once it’s received, we will call you and review what your options are, and what co-payments are for each option. Unfortunately there is no magic wand when it comes to insurance, as they are not looking out for your best interests…only how they can spend the least amount of money. We are here to do the best treatment that is available and fits your financial needs. That being said, we will always give you as many options that will NOT compromise your treatment. Please call Dr Langer at 718-339-6544 if you need any further information.

Posted in: Articles, Cosmetic Dentistry, Insurance Plans, Uncategorized

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