Dental Insurance 101 – Where we answer your most common questions!

We get that insurance can be confusing – What is a deductible? Why doesn’t my insurance cover that at 100%? Are you in-network with my insurance? The questions are endless! But we have the answers. Here is some information on the questions we hear most at Bite Size!

At Bite Size Pediatric Dentistry, we participate with most major dental insurance plans as a Preferred Provider Organization (PPO). Dental PPO plans offer a unique feature where a dentist who is an in-network provider agrees to contracted fees with the insurance company, meaning you get a reduced rate when paying your co-insurance and are able to choose your dentist, rather than being assigned one (which is a feature of HMO plans).
We are an in-network provider for the following insurance carriers:

• Metlife
• Blue Cross Blue Shield (Dental Networks of America network)
• Guardian
• Delta Dental                                                                                 
• Aetna
• Cigna
• Ameritas

*We currently do not accept DMO, HMO, Medicaid, Public Aid, or All Kids dental plans.

So you might be wondering – what is a”deductible” or “co-insurance”? Here are the answers to some of our frequently asked questions about insurance!

• Deductible: Most dental plans have a plan deductible – this means, the insurance company has created a specific dollar amount that must be satisfied by the patient before the dental plan will contribute to the cost of your treatment. Deductibles do not always apply to all services – each individual dental plan has a different deductible amount and rules to what services the plan deductible applies to.
• Co-insurance: Co-insurance is the percentage that your dental plan covers on a particular service. The percentage left over is the your responsibility. For example, for a routine cleaning and exam, MOST insurance companies cover 100%, meaning your co-insurance for these services would be 0% and you wouldn’t have to pay anything. If your insurance covers 80% for a filling, your co-insurance due is 20%. Co-insurance does not mean the insurance plan is not in-network with your dental provider, these are just the percentages that are assigned for your specific plan.
• Something to remember: If your family has dental coverage through a specific insurance company and a friend has coverage from that same company, your benefits may be different. Not all dental plans from an insurance carrier are exactly the same – deductibles, yearly maximums, and co-insurance can be different from plan to plan.
• Use it or lose it: Get to know your insurance! Are you covered for 3 cleanings a year? Are xrays covered? Does your plan renew in January and your benefits “re-start”? Every plan is different and knowing the details of your dental plan will help you make the most of your benefits!

Have more questions? Feel free to call your insurance carrier or call our office! We would be more than happy to assist you with any questions 🙂