Fact
Your insurance company may send you a notice stating that our dental fees are above “the usual and customary” (UCR). The fact is THEIR benefits are too low. Insurance companies take a survey of a geographic area, find the “average fee” out of all fees totaled, then they take 80% of that fee and determine it to be “usual and customary”. Included in their survey are discount and managed care clinics. These have greatly reduced dental fees (they generally use the poorer quality dental materials) which bring down the “average fee”. Any dentist in a high quality private practice will have fees defined by insurance companies as higher than “usual and customary”.

Fact
In 1971, your dental insurance benefits were approximately $1,000 per year. Some 35 years later, you will note that your benefits are still about $1,000 per year. Figuring a 6% rate of inflation per year, you should be receiving over $5,000.00 per year in dental benefits, but are you? NO! Your premiums have increased, but your benefits have not. Therefore, dental insurance is never a pay-all; it is only an aid.

Fact
Many plans tell their participants that they will be covered “up to 80% or up to 100%”, but do not clearly specify plan schedule allowance, annual maximum or limitations. Remember, the amount a plan pays is determined by how much your employer paid for the plan. You get back only what your employer puts in, less the profits of the insurance company.