Excellent dental care is available in our office regardless of whether you have dental insurance or not. However, for our patients who do have the benefit of dental insurance, there are some things you should know about how it works.
Our office is an in-network provider:
- Delta Dental (including Tricare)
- United HealthCare and Humana/CompBenefits
- Aetna, DeCare
- most Blue Cross Blue Shield plans
We only accept PPO plans and unfortunately cannot submit claims for patients with HMO plans, Medicare, or Medicaid. If your insurance company is not listed, it is still very likely that you can use it (and receive benefits) in our office.
- The average dental plan usually offers a yearly maximum cap of $1000-$2000. Dental plans will rarely, if ever, pay for the completion of all your dental care, but instead, they are meant to assist you financially. Ocean Breeze Dental and our office staff will be more than happy to discuss options with you on how to maximize your dental benefits.
- Insurance companies cover a percentage of what they consider “usual and customary.” On occasion, you may receive notice that some dental fees are “above the usual and customary.” Insurance companies determine their reimbursement level by assessing a geographical area, calculating the average fee, and then they decide that 50% or 80% of the average fee is “customary.” Included in this assessment are discount dental clinics and managed care facilities, which have severely reduced fees that bring down the average. Any doctor in private practice will have fees that insurance companies consider “higher than usual or customary.”
- Many insurance companies do NOT recognize (or provide benefits towards) many routine and some newer dental services (such as pulp caps, sedative fillings, cosmetic veneers, dental implants, Arestin, whitening/bleaching, fluoride varnish, etc.) Just because your insurance may not cover some of these procedures doesn’t mean that they are not the best procedure for you.
- Dental benefit plans vary even within the same employer, so your dental benefits may be different from your co-workers depending on the plan you chose.
We make every effort to present our patients with the best dental care and dental solutions possible for their individual situation. When we write your treatment plan, our initial proposal often will not take into account the limitations of your insurance policy. Our doctors believe their patients deserve the best care possible and therefore will not treatment plan an insurance patient any differently than they would one of their own family members.
Please do not hesitate to ask if you have any questions regarding your insurance or our office policies.