Dental Insurance – Worcester, MA

How Dental Insurance Works

Dental insurance isn’t too different from other types of insurance in the sense that you, the policyholder, are expected to pay a monthly fee in exchange for the benefits you receive. That said, there are some key points to keep in mind, such as:

• The majority of policies are based on a calendar year, meaning that your benefits activate in January, continue through December, and do not roll over at the end of the year—they renew, and your deductible returns to $0.
• You must meet your deductible before your insurance company agrees to pay more for minor or major restorative services.
• Your annual maximum is a designated amount of money provided to you by the insurance company; this is the most they’ll agree to pay within a single year.

Since most insurers agree to cover between 80% to 100% of preventive care costs, it’s highly recommended that you continue attending your biannual checkups, as they’ll be of little-to-no cost to you. Minor and major restorative care, depending on the nature of the treatment, is partially covered, though different policies apply different definitions to particular services, so you should always review the details of your plan before committing to a specific procedure.

What Is the Difference Between Dental & Medical Insurance

It’s worth distinguishing the difference between dental and medical insurance; dental insurance is designed to act as a preventive type of insurance, whereas health insurance is the opposite, and is intended to provide financial assistance after the problem has occurred. Dentists and insurance companies alike understand that it’s more expensive to treat oral health problems than it is to prevent them from occurring in the first place; this is why checkups and cleanings are often fully covered.

In-Network vs. Out-of-Network

The main differences between “in-network” and “out-of-network” plans have to do with their deductibles, premiums, and annual maximums. The benefits, or coverage, will also vary, and you’ll also probably notice that it’s generally cheaper to visit a professional who is in your insurance plan’s network. 

In-Network Coverage

Elite Oral Surgery Associates is proud to be an in-network provider with Blue Cross Blue Shield, MetLife, MassHealth, UnitedHealthcare, and many others! By contracting with these specific companies, we’re able to ensure that you’re paying the least amount possible for the high-quality services you’re receiving. We’re also happy to accept and file claims for many other major plans so that you can make the most of your coverage.

Out-of-Network Coverage

If you decide to go with someone who’s out of network with your individual plan, you might end up having to pay more—but you will still receive the same, high-quality care. In any case, our team would be happy to help you file the paperwork and claims, whether we’re considered in-network or not!