Call 1-646-760-3850 to talk to our New York Dental Insurance Specialist, Diana!
There are four (4) different types of dental insurances:
In-Network vs. Out-of-Network:
At Making You Smile we are an in-network/participating provider with a wide range of PPO, EPO and employer table of allowance providing you with the highest quality of care while maximizing your insurance benefits. Get in touch now for your ”Customized plan benefit review”.
There are different parameters to be aware of to best understand how dental insurance works. These parameters are determined and negotiated between your employer (or yourself, if you purchased the insurance plan directly) and the insurance company. The outcome of the negotiation is a specific “insurance plan” that is given a “group number”. The insurance plan is an agreement between the employer and insurance company regarding your dental benefits.
As your dental office, it’s our responsibility to do everything we can to facilitate your understanding of your insurance plan and to maximize your benefits within the rules of that plan. Though we don’t have access to the complete contract defining the rules of your insurance plan, we do our best to inquire on your behalf so we can clarify any questions you may have.
Here are some of these parameters:
Frequency & limitations:
Depending on your employer’s generosity your insurance plan will have some limitations:
Would you like to know if your plan will help with your first dental visit or first dental consultation? Do you want to know exactly what your plan covers? Email, text or call us with your insurance card details and we will find out for you. Or simply fill out our contact form.
What are insurance plans?
An insurance plan is the combination of the rules governing your dental insurance such as deductibles, copayments, and limitations. These rules are determined and negotiated between your employer (or yourself if you purchased the insurance plan directly) and the insurance company. The outcome of the negotiation is a specific “insurance plan” which is given a “group number”. The insurance plan is an agreement between the employer and insurance company on your behalf regarding your dental benefits.
Who decides what those parameters (deductible, copayments and limitations) are?
Your employer meets with the insurance company and chooses a dental plan with certain rules. Sometimes the employer chooses two or three different plans to offer to their employees. During open enrolment time, which occurs with qualifying events each year, the employee can choose or change which plan they want.
Can a dental office find out ahead of treatment what the rules of my plan are?
If the policy is in force yes, absolutely. That is what dental offices can do for you. All the office need from you is the plan information, such as your “member ID” & “group number”, which can be found on your insurance card. The dental office will also need some basic information, such as your name and date of birth. Most dental offices can contact your insurance company for you to obtain the necessary information about your plan, which they can give you an overview of upon your visit.
How much time does it take to get the insurance plan details?
Insurance companies rarely have plan details online, so all of us (dental offices and patients alike) have to call the insurance company during business hours, which are usually between 9 am and 5 pm. Gather as much information as possible to be able to answer any related insurance questions you may have. Having that information on hand allows for your dental office to inform you of your financial obligations before any work is done.
At Making You Smile we know how to maximize your benefits. On your initial visit we will review your benefits with you to help you understand how your plan works. Contact us now for a ”Customized benefit plan review”.