Dental Insurance Plans We Accept

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*If you do not see your insurance plan listed, please call our Implants & Gumcare office, the staff will be happy to verify coverage, or make alternate arrangements even if you have no insurance. We can try to work something out!

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Other Financing & Insurance Options

Cash Discounts on Services
Credit Card Discounts
No-Interest Payment Plans
Insurance Accepted & Filed
Medical Insurance Filing
Co-Pay Only Collection
We accept all Master Card, Visa, American Express, Discover Card, Cheque, and Cash.
We are also happy to assist our patients to locate flexible financing options. Payment is expected at the time service is provided. We are happy to assist our patients in completing insurance forms and providing all necessary documentation to maximize insurance reimbursement based on the provisions of their individual policies.

Practice Benefits

  • All PPO Insurances Accepted, Insurance Filed and Medical Insurance Filing Available
  • We Collect Only the Co-Pay and Not the Whole Amount for the Procedure
  • Cash Discounts, Credit Card Discounts and Affordable Payment Plans
  • NO-INTEREST In-House Financing for 90 Days
  • LONG-TERM Third Party Financing Options Through Multiple Third-Party Providers
Ask about Free whitening in time for the Holidays!

Choosing The Right Insurance Plan

Choosing the right kind of dental health insurance plan you need for yourself and your family should take some time. You do not want to choose one too quickly, and the more you know about dental insurance before choosing the better plan you can get.

Private dental insurance will usually be your best choice, but it does depend on your budget. Most dental insurance plans have a waiting period, so you cannot buy a plan and get benefits from it immediately for urgent dental needs.

You will often need to wait for one to three months before you can get basic services such as a filling; and three to six months before you can get an extraction, a root canal, or a crown. You will need to wait a year or longer for services such as bridges, implants, or dentures.

Unlike your medical insurance, dental insurance companies focus on preventive treatment. This means that they will usually pay 100 percent of the cost of dental cleanings, and x-rays. They usually pay about 80 percent of services such as fillings, root canals, and other basic treatments, and only 50 percent of crowns, bridges, and major procedures. Many plans will not pay for cosmetic dentistry or orthodontics.

There is also usually a low cap on dental insurance. This will typically be between the $1,000 to $1,500 range.

One way to get the dental insurance coverage you need is to talk to the dentist you like and find out what insurance plans they accept and ask which one they might recommend for your specific needs.

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Top 6 Dental Insurance Companies at Implants & Gumcare (Based on Claim Data)

Aetna

Cigna

United Health Care

Blue Cross Blue Shield

Delta Dental

MetLife

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Did you know - Dental Insurance?

Buying dental insurance is different than buying a regular health insurance plan. The terms and the focus are often different, and some of the things that you might think are covered may not be covered at all. Dental insurance plans vary considerably between companies, so you will need to look carefully at the details if you are getting individual dental insurance.

The Focus Is Different

Instead of just meeting needs as they occur, dental plans aim for prevention. Many of them will offer 100 percent coverage for preventive care, which will usually cover such things as x-rays, dental cleanings, and check-ups. The higher percentage for preventive care aims to prevent costly procedures before they occur, and will pay a smaller percentage for the actual treatment of larger problems.

Maximum Coverage

Nearly all dental plans will have a maximum amount of payments that they will make each year. The caps are usually set at either $1,000 or $1,500 per year. Many of the more expensive procedures may cost more than this, so it is likely that you will still be paying considerable costs out of pocket. In addition, there may also be a deductible amount.

Partial Coverage

Many dental treatments are only covered by a percentage of the cost. Basic procedures will often pay around 80 percent of the cost, and this may include fillings – amalgam only, reattaching existing crowns, and dental extractions.

Major dental work is usually covered by most dental insurance plans at a rate of 50 percent. This would include treatments such as bridges, crowns, root canals, and dental implants. This means that if you have a root canal and a crown, the total cost could be around $2,000, or more. If the insurance pays 50 percent, you will pay $1,000 for it, plus any co-pays.

Depending on your dental plan, this could end up being the only service the dental insurance plan will pay for because you reached the maximum amount. Of course, they would still pay for preventive dental services.

Pre-existing Conditions

Most dental insurance companies have clauses in their contracts that will prevent you from benefiting by getting dental coverage just when you need to have some major work done on your teeth. In many cases, after you buy a dental insurance policy, you may still need to wait at least 30 days before you can even get any preventive care. Getting fillings and other restorative services may require a waiting period of three months or more, and any major treatments may require a wait of at least six months or more.

When you go to buy dental insurance, it is quite likely that you will need to sign up for a minimum of one year. Some of the more expensive treatments may require waiting a year or more. These treatments often include orthodontics (if covered at all), bridges, and dentures.

Group Dental Insurance

There are also some things you need to know about getting a dental insurance plan through your employer’s group plan. While it may only cost you a few dollars a month for it, it may not be worth it if it is for your whole family. Many times these plans only have a maximum cap of about $1,000 for the entire family. As seen earlier, this cap may not cover much if one or more of your family members need some major dental work.

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Affordable Care Act (ACA)

Dental Insurance Not Required

Under the Affordable Care Act, health plans offered in the Marketplace may also offer dental health insurance. If it is offered as part of the plan, it is included in the cost of the premiums. If it is not part of the plan, you are free to buy the one offered by the health insurance company you choose, or you can buy a separate dental plan.

Dental Insurance for Kids

If you have people in your home under the age of 18, the Affordable Care Act requires that the insurer makes dental insurance available for them – but you do not have to buy it. Adults do not have to have it, either.

Buying Dental Insurance

Before you go and buy any dental insurance, if you have a dentist you like already, check to see what insurance plans they accept and choose one. Look for one that provides the best benefits for you and your family.

Dental Insurance FAQ (General)

Most dental plans cover 100% of preventive services such as annual or semi-annual office visits for cleaning, and X-rays. Other procedures like treatment for gum disease, extractions, fillings, root canals and crown come with deductibles, co-pays and co-insurance determining the patient's out-of-pocket expenses

Most plans come with a maximum annual benefit or coverage limit. This limit usually falls between $1,000 and$2,000

An insurance limit is the maximum amount of money an insurance company will pay you for a covered loss. You'll typically find that the higher your coverage limit, the higher your premium may be. Limits often apply to different types of coverage within a policy

Most dental insurance commonly have what's described as “100-80-50” coverage, meaning it pays 100 percent of the cost of routine preventive and diagnostic care, such as checkups and cleanings; covers 80 percent for fillings, root canals and other basic procedures; and 50 percent for crowns, bridges and major

A copayment (or “copay”) is a monetary charge that your health insurance plan may require you to pay before receiving a specific medical service or supply

Coinsurance is a percentage of the cost for a health service or prescription drug paid by a member after they have reached their deductible

The comprehensive health care reform law enacted in March 2010 (sometimes known as ACA, PPACA, or “Obamacare”).

The Affordable Care Act (ACA), or Obamacare, names pediatric dental benefits one of the 10 essential health benefits that must be included in certain health plans under Obamacare. However, ACA doesn't include adult dental insurance

The dental insurance waiting periods vary depending on the company and plan chosen

Out of network simply means that the doctor or facility providing your care does not have a contract with your health insurance company. In-network means that your provider has negotiated a contracted rate with your health insurance company.

If you have Medicare, your plan may already include dental coverage. Otherwise, the cost of stand-alone dental insurance plans for seniors over 65 will depend on the level of coverage chosen

Balance Billing. When a provider bills for the difference between their charge and the allowed amount from your insurance plan. For example, if the provider's charge is $100 and the allowed amount is $70, the provider may bill you for the remaining $30.

The amount you pay for covered health care services before your insurance plan starts to pay

ACA-compliant just means a policy that adheres to the ACA’s regulations

Out-of-pocket expenses refer to costs that individuals pay out of their own cash reserves

Accident insurance helps you pay for the medical and out-of-pocket costs that you may incur after an accidental injury

A type of insurance in which the insured pays a share of the payment made against a claim

Although there is no one "best" dental insurance plan, some plans may work better than others for you and your family. Plans differ primarily in how much you'll have to pay monthly

Yes. According to the American Dental Association, cost of dental treatments and lack of dental insurance are the main reasons adults aged 18 to 64 don’t seek needed dental care.

Costs will vary depending on your state. Average cost is about $50 monthly per person.

Most dental insurance policies will cover regular checkups and cleanings twice a year. Some dental insurance plans will also cover the expenses related to cavity fillings and orther major work.

All dental insurance policies differ, policy holders should check their coverage limits to find out exactly what is and what is not covered in their unique cases.

The yearly maximum usually renews every year (on January 1 if your plan is on a calendar year). If you have unused benefits, these will not rollover. Use It or Lose It!

If you have met your deductible already, you have every incentive to take full advantage of all health care needs before the deductible resets. Since they reset at the end of each year. Saving you money!

The best way to spend less on extensive dental work is to not need extensive dental work. Maintaining good oral health is to go to your dentist at least twice a year for an exam and cleaning. You will find that problems are detected early and require less costly treatment to repair when you visit your dentist routinely.

Medical insurance focuses more on covering consequences of injury and illness after they happen. And because medical care can be quite costly, medical coverage is designed to protect you from the burden of large expenses. Dental insurance is meant to cover some of the costs associated with your dental care. Routine dental care, like regular checkups and cleanings.

Normally your provider would be the one to make that determintation

The easiest way to maximize your dental insurance is to talk to your dentistry team about your benefit plan

While dental care utilization is at its highest level ever among children, utilization among adults is in steady decline, with only 35.4 percent of working-age adults visiting the dentist in 2012. Only 2-6% of Americans with dental benefits hit their annual maximums. For many patients, 90 percent of dental benefits are left unused each year.

At that time of your appointment your provider will advise you if there's a copayment due for services rendered. Not all plans and services require copays. Please become familiar with your dental benefit plan.

Depending on the plan you choose and where you live, network availability may vary. Refer to your plan documents for network details.

Dental Savings Plans

This alternative to dental insurance offers club members a discount of anywhere between 10 to 60 percent of the usual costs. There are many dentists that honor dental savings plans, and some of them are offered by major insurance companies. There are no annual caps, limits, or waiting periods.

When you need dental care and have a dental health insurance plan, or want help in choosing one, Dr. Kumar T. Vadivel, DDS, FDS RCS, MS, a Board-certified Periodontist, can help you. He has offices in the Carrollton, TX and Grapevine, TX areas. You can contact his office today at (817) 756-8578.

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