The Truth about Dental Benefits

The Truth About Dental Benefits

October 2012

What is dental insurance?

Dental insurance is meant to help cover a portion of the costs associated with your dental care such as

– Diagnostic and preventive care.– Periodontal maintenance and cleaning.– Basic restorative procedures like fi llings.– Oral surgeries ranging from tooth extractions

to tissue grafts.

PiedmontPeriodontics.com

Dental insurance and the benefi ts provided to patients constantly change and can often

prove confusing to patients.


Sources of Confusion

1) Provider Assignment– DMO/HMO insurance plans assign patients to

specifi c providers.– DMO/HMO patients only receive benefi ts at

their assigned offi ce(s), regardless of existing relationships between their dental provider and their insurance company.

To clarify, even if a dental offi ce has a contract with an insurance company, DMO/HMO patients will not receive any benefi ts at the offi ce unless they have been assigned to that particular provider.



1) Provider Assignment2) Waiting Periods

– Private-self insured plans may have waiting periods for major services including- chronic gum disease

- crowns

- dentures

- periodontal procedures

– Dental offi ces may not be aware of waiting periods when scheduling a patient’s surgery.



1) Provider Assignment2) Waiting Periods3) Frequency Limitations

– After procedures, patients receive regular maintenance cleaning appointments, usually every 3 months, to ensure optimal oral health.

– Benefi ts may not cover each and every cleaning.



1) Provider Assignment2) Waiting Periods3) Frequency Limitations4) Maximum Payouts

– Unlike medical insurance, dental insurance has a maximum payout each year.

– Amount of payout will vary depending on plan.



1) Provider Assignment2) Waiting Periods3) Frequency Limitations4) Maximum Payouts5) Referrals

– Referring dentists make recommendations based on each patient’s specifi c dental needs and do their best to accommodate patient insurance plans.

– Piedmont Periodontics goes the extra mile to ensure that we maximize each patient’s benefi ts.


At Piedmont Periodontics, our team has over 40 years of combined experience working with insurance companies. We will work diligently with you to provide the most accurate estimates of what benefi ts are available to you.Contact us today to set up a complementary dental and insurance consultation.


The Truth about Dental Benefits

Health & Medicine

Transcript of The Truth about Dental Benefits