Dental Insurance Myths, Busted

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Here at SLO Smiles, keeping it real is kinda our thing. That’s why we’re about to bust the most common (and dangerous!) dental insurance myths out there, starting now.

Myth #1 – Treatment Can Wait, Right?
Fact – No, it can’t.

Not only is it unsafe to wait on recommended dental treatment, but could also cost patients more in the long-term. Why? Well, dental plans have an annual maximum allowance. That means insurance benefits do not rollover year to year. All that to say, take care of your dental health by taking full advantage of your benefits.

Myth #2 – I have dental insurance, so all my dental care costs are totally covered.
Fact – Unfortunately, that isn’t the case.

Dental insurance is different than other types of health insurance. While dental insurance can help offset your dental care costs, it will not take care of 100% of your needs. That’s because benefits are defined per year and not open-ended based on need. So, once you hit your maximum allowance (typically between $1,500-$2,500 annually), your dental plan will stop paying claims…even if you still need care. It’s also good for patients to know that most plans only pay for a portion of dental care costs, and you are responsible for making up the difference.

Myth #3 – If the treatment my dentist recommends isn’t covered by dental insurance, I must not really need it.
Fact – This is one of the most perilous myths of all, and it’s totally false!

As we outlined above, dental insurance benefits are not based on need. They’re generally designed to provide coverage for basic (often preventative) services. Sadly, many dental insurance providers skimp out by downgrading optimum treatment to the bare minimum option in order to save themselves money. This isn’t good for patients, because it isn’t prioritizing patient health and wellbeing. Keep in mind, that when our dedicated dentists recommend a treatment, it’s because it’s what’s best for you and your health. Insurance providers simply don’t operate that way.

Myth #4 – My insurance company says you charge too much, and that’s why I have more out-of-pocket.
Fact – That’s simply untrue.

Patients need to know that insurance companies decide in advance what fees they will “allow” for each service. This allowance is often called a “fee schedule”, or referred to as a “UCR”, and they are not in any way tethered to reality. Dental offices that choose to accept this type of fee schedule spend less time with patients, use inferior materials, and often see considerably more people day in and day out in order to make ends meet. Here at SLO Smiles, we think that system is wrong because it isn’t what’s best for the patients we care deeply about. Instead, we choose to go our own way, providing only outstanding care using the highest quality materials available. At SLO Smiles, we will never provide sub-standard care simply to comply with insurance company contracts.

Now that you’re equipped with the facts, hear this – dental insurance exists to assist you in paying for dental care services. When it comes to preventative care, many plans out there provide practical support, but fail to cover you when restorative or corrective work is necessary. Knowing that, here at SLO Smiles in San Luis Obispo, we do everything under the sun to maximize your benefits, while educating patients to be prepared for out-of-pocket expenses.

Take care of your smile! Contact the friendly SLO Smiles team to book an appointment today at (805) 541-0550.


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New patients are always welcome at SLO Smiles. Our friendly San Luis Obispo dental team looks forward to meeting you!