Dental Insurance Myths

MYTH: I can’t go to the dentist if I don’t have dental insurance.

FACT: Absolutely not true. Many people without dental insurance find that regular dental care is affordable, especially since preventive treatment helps to prevent future problems, before they become more serious and expensive to treat. Regular dental visits are an important part of your overall health, as studies show that poor dental health is linked to other medical issues such as diabetes, oral cancer and heart disease.

If you don’t have dental insurance, talk to your dentist about payment options that may be available to you.

MYTH: My dental plan should cover all of the costs of my dental care.

FACT: Dental plans are designed to help pay for a portion of your dental costs. Many plans cover 100 percent of basic preventive and diagnostic services, and then between 50 percent and 80 percent of restorative care and other treatment needs. Your cost depends on the services and procedures that are a part of your dental benefit plan.

MYTH: My dentist has recommended a more expensive procedure that is only partially covered by my dental plan. Is my dentist trying to take advantage of me?

FACT: Absolutely not. While your plan may only cover certain treatments, you and your dentist should always decide what is best for you. Dental plan administrators are not usually dental professionals and therefore are not in a position to decide which treatments are right for you. Don’t let the plan coverage decide your treatment for you.

MYTH: A note on my explanation of benefits indicates that my dentist’s fee is more than was allowed by the dental plan for a procedure. Is my dentist charging me too much?

FACT: Your dentist is not over-charging you. Dental plans set limits for the amount paid for any treatment based upon a fee schedule — the plan’s fee schedule, not your dentist’s actual fees. The administrator will pay either a set percentage of your dentist’s fee, or a maximum plan benefit, which depends on the benefit level of your specific plan.

MYTH: My dental plan is better-able to determine the fees for my dental needs than my dentist.

FACT: Your dentist is educated to diagnose and treat oral disease and promote oral health and disease prevention. This requires a pre-dental degree from a college or university, followed by a minimum of four years of dental school. A dental specialist takes two to four years of training after dental school. Your dentist is a doctor of oral health who has taken the time to study your oral condition and develop a treatment plan for your specific dental needs. The cost for your care is based on what treatments your dentist recommends and your personal needs.

Dental plans often limit your options through a contract with your employer and are not based on your individual needs. So, be sure to talk with your dentist about your individual treatment plan and any questions you may have about your dental benefits.