Dental Insurance – How It Works

Five Star Cosmetic Dentistry Patient Dental plans aren’t really insurance in the way other things are. Traditionally, you are insured against catastrophic losses. You pay your homeowners carrier thousands of dollars a year, and then if your home or property gets destroyed by fire, accident, or a crime, you are reimbursed for the damage and are able to keep your home. The money spent gives you peace of mind that you will be able to survive a catastrophic loss. Dental plans, on the other hand, are geared toward providing a maximum fixed quantity of benefits every year. The companies need to charge enough for the premium that they can pay for your benefits and have some money left over for their operating expenses and a profit. Dental expenses are a more predictable type of expense, and a dental plan doesn’t really expose the carrier to any significant risk because every plan has an annual allotment of benefits.

Dental insurance plans are designed to provide you with a basic standard of general dentistry. While some cosmetic dentistry procedures are covered by dental insurance plans, they are only covered at a functional level. The insurance company may help you pay for a crown to physically protect your tooth but won’t pay the extra cost required to make it beautiful. Furthermore, some dental insurance plans maintain lists of dentists called “preferred providers” or “network dentists” who are willing to discount their fees in order to receive referrals from the insurance company. Don’t expect any expert cosmetic dentists to agree to these insurance company terms. Dental plans will also limit their coverage of cosmetic dentistry procedures, in order to control their costs. They usually completely disqualify them from any coverage and are designed to provide you with a basic standard of general dentistry.

We will be happy to help you with your Insurance and maximize your coverage. Although Reseda Cosmetic Dentist Dr. Vorperian is not dental provider for any of the DMO plans. You may use your Insurance if you have out of network” or indemnity coverage.

Other dental insurance topics that will be added later to this site:

Facts you should know about dental plans – It isn’t intended to be coverage for all your tooth care needs. You will be the least frustrated with it if you take it for what it is—a benefit to help you defray some of your dental care costs.
A discussion of Delta Dental plans and some of the trickery they employed to try to manipulate the dental marketplace.
Privately purchased dental plans – When you buy it as an individual, you are getting a benefit plan that is very different from what an employer will provide. This page will help you understand how this type of coverage works.
Dental plan limitations – These companies have many provisions in their contracts to limit their costs. This page will help you understand those limitations.
Preferred providers – Many plans feature a list of “preferred providers” or “in-network dentists.”
Usual and customary fees – These companies set a “usual and customary” fee for each recognized procedure. Here’s how that system works.
Company tactics – There are many tactics that they use to help control costs. Some of them are reasonable, but some are deceptive and manipulative.