“Why doesn’t my insurance cover what is being recommended??”

Let’s start by talking about dental insurance. Dental insurance is unlike medical insurance. Dental insurance is a benefits plan that is agreed to by your employer and the insurance company. The insurance company sets forth these plans that dictate what will be covered based on what an employer decides to purchase. The insurance company also decides how much they will reimburse for each procedure and how much of each of those procedures they will cover.

Dental insurance began back in the 1970’s as an extra benefit to encourage people to visit the dentist. In the early days, insurance covered up to $1,000 per person per year and there were no restrictions on how that money could be used. This made dentistry more affordable to more people. As time has passed, the insurance companies have steadily raised your premiums, but still, even today, most plans have a maximum of $1,000. Now, there are also restrictions and limitations on how you can use your dental benefits. Some plans have a “restricted network” of dentists, dentists that have agreed to accept lower fees for this plan. Most insurances still allow you to see an “out of network” dentist, but w=your benefit is lower than by seeing an “in network” dentist. Limitations can take a number of forms, most common is not replacing missing teeth that were missing before coverage began. Some also limit the frequency of certain procedures, regardless of actual need for these. Add to this that insurance is always looking to cover the least expensive option, andyou ca see why we do not participate in these plans.

As stated above, we do not participate in any of the insurance plans, meaning we do not sign contracts to agree to accept lower benefits. We do accept all insurance, but we strongly believe the decision for your care should be a decision made between yourself and Dr. McDowell. We customize our treatment options to your needs, we do not want an insurance company, who has never examined you, deciding what they feel is “best” (insurance talk for least expensive) for you. There a few exceptions, but most insurances will cover your visits here in our office.

If you have any questions about your insurance, or would like to find out more about our office, please give Bettina a call at 978-343-4031. Please visit our website for more information about our practice also: www.brianmcdowelldds.com

Dr. McDowell

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