THE GREAT INSURANCE BATTLE
We know that understanding insurance isn't always the easiest part of your day, so we thought we would answer a common question for our patients in the hopes to provide some clarity.
Q: What is the difference between being in-network vs. out-of-network?
A: This is answer is best explained with an example; please note this is only an example. Let's say you go to your care provider and your total fees for services provided is $250.
- If your dentist is in-network this means your doctor is part of a negotiated rate with your insurance and so the fees are reduced to $175 (vs $250). In this example, your insurance pays $140 and you pay the remaining balance of $35.
- If your dentist out-of-network and the total charge is again $250, your doctor is not a part of the lower negotiated rate. Your insurance still pays the $140 and you pay the remaining balance, which is $110, meaning you pay more out of pocket.
In summary, being out-of-network means you'll have to pay a percentage of the total cost, depending on your personal dental coverage plan.
DENTAL BENEFIT PLANS WE WORK WITH:
Below is a list of Insurance Companies that we are contracted with as Participating Providers ("In-Network with")
- Aetna
- Delta Dental Premier, or' PPO-Premier'
- Not 'Delta Dental PPO'
- Call Delta and ask them if you have "Premier coverage"
- If your plan is "PPO Only", ask them if you have out-of-network benefits so that you can still use your plan at our office
- 'Humana Medicare'
- Not 'Humana PPO'
- MetLife
- Principal
It is ultimately the patient's responsibility to verify their insurance plan's participation with our office. We try our best to receive information from the insurance company from your behalf but are more limited as of 2024.
Bigger Dental Offices (Perfect Teeth, Comfort Dental, Modern Dental, etc) are financially able to afford in-network plans with most insurance companies. We are still able to serve patients as an out-of-network provider - check to see if your plan offers "out-of-network benefits".
NO INSURANCE? NO WORRIES!
We offer our very own in-office direct Diamond Discount Plan! This is a reduced fee schedule plan with a 12 month membership fee. Call us to inquire about details!
Don't let your lack of dental 'insurance' or benefits prevent you from getting the quality dental treatment you need and deserve.