Insurance

To assure the most cost-effective care, Dr. John’s Family Dentistry works with a variety of dental insurance companies. However, because there are so many different dental plans, it pays to check with us in advance to see how fully your treatment will be covered. Here is a list of insurance plans that provide at least partial (some full) coverage for our services:

  • Aetna
  • Ameritas Life
  • Anthem
  • Cigna
  • Delta Dental
  • Dentemax
  • Forum Health
  • Guardian
  • Humana Dental
  • Medical Mutual
  • MetLife
  • NGS
  • UFCW
  • United Concordia
  • United Health Care

(Please note that this list is subject to change.)

Here are some questions that our patients have asked, along with clear answers:

What is the difference between dentists who are “in network” and those who are “out of network”?

If a dentist is “in network” with your insurance company, then he or she has agreed to accept lower fees for patients with that insurance. Any relevant co-pays are based on those lower fees.

If a dentist is “out of network, patients can still go to that dentist. The insurance company will partially pay for the dentist’s services, with the patient responsible for the rest.

The level of insurance company participation for “in network” and “out of network” dentists differs by health plan.

Does insurance coverage have anything to do with the type of dental procedure involved?

Yes. Insurance companies generally recognize three types of services.

  • Preventative care (like checkups, cleanings and X-rays) is usually covered most by insurance companies, and often at 100 percent.
  • Basic care (fillings, etc.) is often covered at around 80 percent, with the patient responsible for the remaining 20 percent of the cost.
  • Major care (crowns, root canals, dentures, etc.) is usually covered at around 50 percent, with the patient responsible for the rest.

Is there anything else I should be aware as far as insurance is concerned?

Yes,  your annual maximum. Most insurance companies have a yearly allowable maximum for treatment. Once a patient has reached this ceiling, all payment becomes the patient’s responsibility for the remainder of that calendar year.

If you have a question about anything to do with our services,
we’ll be glad to answer it with as much explanation as you’d like. Just ask. 🙂