Reflections Dental Spa
Family & Cosmetic Dentistry

I’m really confused about my dental insurance and how it works. Can you give me some details?

We get a lot of questions about dental insurance! The truth about dental insurance is that it is not a true insurance to cover a loss. It is a contract usually between your employer and the insurance company to help employees pay for dental care. 

The plan specifications are based on what the employer purchased as far as the amount of benefits and premium is concerned. So to accommodate budget restrictions of the employer, each insurance company creates various restrictions to make it profitable for the insurance as well as affordable for the employer. Most benefit plans cover only part of the cost.

An in-network provider of an insurance company has contracted with that company to provide services at a discounted fee for its members. They are contractually obligated to collect the patient portion or co-pay not to commit insurance fraud. Insurance helps patients get recommended care since there is more compliance from the patient due to perceived benefit from the insurance.

We try our best to estimate your portion based on the insurance breakdown provided by the company. Sometimes pre-estimates are sent. Irrespective of all this and the best of our intentions, plans change mid-year, employers change options mid-year, insurance policy changes occur, and frequency limitations or procedural limitations can occur.

We expect you to inform us if any changes have taken place in your enrollment, coverage or insurance. We work with multiple insurance companies, and without your input and help, it is impossible to keep current on your benefits. We bill your insurance companies as a courtesy to you, but ultimately you are responsible for your accounts.

We at Reflections Dental Spa, always try to work with your individual situation and work with your insurance. We are in-network with most of the PPO plans to help you maximize your benefits.

Ultimately our duty lies with you as our patient, and our diagnosis and treatment recommendations are based on what are in your best interest and not what the insurance dictates. Any help from them in improving and maintaining your dental health is a bonus. But determining your treatment needs solely on what your insurance dictates can be detrimental to your dental health.

Our patient Coordinator Carlene, can answer you any questions or concerns you have regarding your insurance benefits and coverage. We strive to build our practice on the principles of honesty and integrity and are passionate about oral care!