Insurance & Financing

How Dental Insurance Works

Dental insurance helps offset the cost of care. It is not designed to fully cover every recommended treatment. Most dental plans are built around contract rules that may have little to do with what is best for your health, comfort, function, or long-term result.

Plans typically include a deductible, an annual maximum, percentage-based coverage, and frequency limitations. A plan may pay a higher percentage for preventive care and a lower percentage for larger restorative care. Some plans replace clinical judgment with rules about timing, replacement frequency, alternate benefits, or missing teeth.

Treatment decisions should not be dictated solely by insurance. Insurance can be useful, and we work hard to help patients use benefits wisely, but the best dental plan is the one based on your diagnosis, your goals, and your long-term health.

Estimates vs Reality

We provide our best estimate based on the information available to us at the time. That may include the plan information you provide, benefit details available from the insurance company, and our experience with similar claims.

Insurance companies do NOT guarantee payment in advance. Even when a plan gives an estimate or pre-treatment estimate, final payment is determined after claim processing. The insurance company may process a claim differently because of eligibility, plan limitations, remaining annual maximum, deductibles, missing information, waiting periods, or internal plan rules.

All estimates are just that—estimates, not guarantees.

Common Misunderstandings

• "Covered" does not mean free. It usually means the plan may contribute if plan rules are met.
• Estimates are not guarantees. Final payment is decided after claim processing.
• Insurance companies may downgrade benefits to a lower-cost alternate procedure.
• Annual maximums are often lower than patients expect, especially for larger treatment plans.

Payment Policy

Payment is due at the time services are rendered. We help estimate insurance and maximize benefits whenever possible, but patients are responsible for any amount not paid by insurance. Patients are also responsible for understanding their own benefits, including deductibles, annual maximums, waiting periods, excluded services, and frequency limitations.

Our team is happy to help you interpret available information, but your insurance plan is a contract between you, your employer or plan sponsor, and the insurance company. The insurance company makes the final claim decision.

In-Network vs Out-of-Network

We focus on providing the best care—not limiting treatment based on insurance restrictions. If a plan is out-of-network, we can still help you understand likely benefits and how claims may be filed.

Insurance Plans

We are in-network with many major dental insurance providers, including:

• Delta Dental
• MetLife
• Cigna
• Aetna
• Guardian
• UnitedHealthcare
• and many more

If you do not see your plan listed, contact our office or your insurance provider to verify your benefits.

Out-of-network? No problem. Many patients use out-of-network benefits successfully.

Common Coverage Patterns

These are general patterns only. A crown may be covered at 50% by one plan but denied entirely by another depending on waiting periods, frequency limitations, and plan details.

Procedure	Common Coverage Pattern
Preventive visits	Often covered at a higher percentage, subject to frequency rules.
Fillings	Often covered after deductible, depending on material and plan rules.
Crowns	Often considered major care with deductibles, annual maximums, and replacement limits.
Dental implants	Coverage varies widely. Some plans exclude implants or cover only parts of treatment.
Invisalign	Often tied to orthodontic benefits, lifetime maximums, and adult coverage rules.

Coverage varies significantly by plan. Contact your insurance provider or our office for details regarding your specific benefits.

Financing Options

Learn More About Your Coverage

Insurance FAQ