At Norcross Family Dentistry, we will do our best to identify as many of the details of your individual dental benefit plan as we can. Please be aware that we have hundreds of different benefit plans to keep track of among our patients. Ultimately, it is your responsibility to be familiar with the specific details of your dental benefits.

Because dental benefit plans rarely cover 100% of all treatment, it is important that we not allow your plan to determine the standard of dental care that we provide to you. Our Doctors will present recommended treatment plans based on your dental needs, not based on whether or not the treatment will be covered by your plan. You will then determine how you choose to proceed with the recommended treatment.

There are several different parts of a dental benefit plan that can affect payment. It is important that you read through this list and identify those that apply to your plan.

• Most benefit plans have a deductible.
• Most benefit plans have an annual maximum.
• Plans have a designated benefit year.
• Some benefits plans have a waiting period for certain types of treatment.
• Some plans have a missing tooth clause.
• Most plans have frequency limitations for treatments.
• All plans have exclusions (treatment that is not covered by the plan).
• With crowns and bridges, benefits are either paid based on the day that treatment begins or the day that the treatment is completed.
• If you have double coverage, you cannot assume that this means your treatment will be covered at 100%.
• Benefits for fluoride, sealants, night guards, etc. vary greatly between plans.

Also, be aware that treatment performed by a previous dental provider may also affect whether or not a treatment we provide is covered by your benefit plan.

 

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