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Understanding Dental Insurance
Next, we have the missing tooth clause. This is a provision in some dental insurance plans that states the plan will not cover the cost of replacing a tooth that was missing before the policy was in effect. This means if you had a missing tooth before obtaining your dental insurance, the cost of replacing that tooth would not be covered by your plan.
Frequency limitations are another aspect of dental insurance to be aware of. These are restrictions placed on how often certain procedures can be covered by your insurance plan. For example, your plan may only cover dental cleanings twice a year or a specific type of dental restoration every few years. Make sure to review your plan’s frequency limitations to avoid any unexpected out-of-pocket expenses.
Lastly, let’s discuss downgrading. This is when your insurance plan covers a less expensive alternative treatment instead of the one recommended by your dentist. For example, if your dentist recommends a tooth-colored filling, your insurance plan may only cover the cost of a silver filling, leaving you responsible for the difference in cost.
At our dental practice, we accept dental insurance as a courtesy to our patients. We are happy to wait 30 days for insurance to pay, but it’s important to remember that if your insurance denies coverage for any reason, the payment of the bill is ultimately the patient’s responsibility. Understanding the limitations of your dental insurance will help you avoid any unexpected expenses and ensure that you are prepared for any out-of-pocket costs.
