What You Need to Know Before Getting Out-Of-Network Dental Care

Life can come at you pretty fast, and sometimes, you might need to seek dental care from an out-of-network provider. But despite the numerous reasons for needing to go outside of your health insurance plan for this care, you are essentially taking a gamble by seeking a dentist outside of your benefits package. Keep reading to learn more about a few of the things you should know if you’re planning to see an out-of-network dentist.

You’re Taking on Additional Financial Risks

The purpose of dental insurance is to make receiving dental care as affordable as possible. The “safety net” metaphor comes to mind; by spending a little now, you can avoid spending a lot later on when things go south. However, there are several different financial risks involved with making the decision to seek out-of-network care, including:

• Loss of Health Plan Discount: Dentists in a network have a set agreement on the rate that they charge for care. When you choose a dentist who is out-of-network, you are not guaranteed these same discounts.
• Balance-Billing: An out-of-network practice can bill you for anything leftover after your dental insurance pays its part. If your dental insurance doesn’t agree on the cost of treatment, you could be left with a bigger bill that you will need to pay out of pocket.

You May Experience Quality Care Issues

Insurance companies do research before they accept any dental practice into their network. If a practice shows that they are not meeting certain standards, they will not be accepted—or can even be dropped. You don’t want to roll the dice and pick an out-of-network dentist, only to find yourself receiving lackluster care!

You’ll Inherit More Responsibility

Finally, it’s also worth noting that when you opt out of in-network dental care, you’re ultimately accountable for much more. For instance, you might need to research the best available care in the area, request your own dental records, and even negotiate your own rate. This is quite a lot to handle, and when seeking treatment is already on your mind, it’s quite easy to feel a little overwhelmed.

When it comes to your dental insurance, by choosing an in-network provider, you can get the most out of your benefits and ultimately save yourself money, time, and effort!

About the Practice

Our team here at Elite Oral Surgery Associates is excited to offer patients and families in Worcester and the surrounding area an outstanding level of dental care. We’re also thrilled to work with most major dental insurance plans as well as MassHealth. If you have any questions about the blog or would like to arrange a visit for you or a loved one, feel free to contact us online for further information.