| For us to provide the best possible care to your child in an atmosphere of trust, I would like to share with you some factual information about your dental insurance. Fact
This is your insurance for which you are responsible. We are here to help you determine and receive your benefits, but in reality you are responsible for the total cost of your child’s dental care. As a courtesy, we file your insurance so you will receive the maximum benefit due to you as provided by your dental insurance plan.
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”.
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.
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.