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How to Maximize Your Dental Insurance at an Out of Network Dentist

October 1, 2018

Filed under: Uncategorized — drlindsey @ 6:04 pm

dental insurance paperworkDental insurance is a remarkable tool that can help you afford the high-quality oral healthcare you deserve. You may have read that it is always best to visit an in-network dentist in Ft. Collins to get the most out of your coverage — but is that really the case? In fact, many policies allow you to visit any licensed dentist. Even at out of network care providers, you can save a significant amount of money on your treatment.

Dental Insurance Basics

There are several different types of dental insurance plans, and many of them, including PPO and indemnity plans, contain a provision for patients who want to visit an out of network dentist. Regardless of which type of dentist you choose, here are some basics on how you can expect your insurance to help pay for your treatment:

  • Preventive care is typically covered at a rate between 80 and 100 percent, while restorative care may be covered at a rate between 40 and 70 percent.
  • Insurance plans enforce an annual maximum, which is the most that the benefits provider will pay out for treatment within a calendar year. This yearly allowance is often between $1,000 and $1,500.
  • The folks at the dentist’s office will help to verify your coverage, explain how it works, file claims for you, and even follow-up with the insurance company.

Paying for Care at Out of Network Practices

If there is a dentist you like who is out of your insurance’s network, you can still get huge savings when you use your plan. Here are some tips to help you afford a healthy, beautiful smile:

  • Schedule a checkup now. If you have a portion of your annual maximum left for 2018, use this to get a routine checkup. Your exam will reveal if you need any restorative work, and you can use 2019’s coverage to complete your treatment. Or, you may even have enough of your annual maximum remaining to get your procedure done this year.
  • Ask about financing. Some major procedures cost quite a bit of money, regardless of whether your dentist is in your insurance’s network. Many practices will help you apply for CareCredit to break up your bill into manageable monthly chunks.
  • Use your savings plans. Both flexible spending accounts (FSAs) and healthcare savings accounts (HSAs) allow you to set aside tax-free money throughout the year to pay for dental and medical expenses. Remember that FSA funds typically expire at the end of the calendar year, so you only have a few months left to make use of that money.

Don’t let network boundaries stop you from seeing a dentist you trust! You may still be able to use your insurance to get the care you deserve at a reasonable rate.

About the Author

Dr. Shiloh Lindsey is proud to provide comprehensive general and cosmetic dental care to families in Ft. Collins. She has been practicing the art and science of oral healthcare for nearly 20 years. The knowledgeable team in our office is happy to help patients understand and get the most out of their insurance coverage. If you have questions about our payment or insurance acceptance policies, contact us at 970-482-3166.

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