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Dental Insurance Coverage

Approved insurance coverage formFor many patients, visiting the dentist is associated with stress and fear. You may be surprised to hear that people often say the most stressful thing about dental office visits is financing. In fact, more patients report skipping dental office visits because they’re worried about the cost than any other reason. At New Image Dental, we are dedicated to providing patients with a stress free dentistry experience, and that includes paying for your necessary dental care. In addition to offering affordable treatments, we work with patients to maximize dental insurance coverage, and we are in-network with most major PPO providers. Most importantly, we promise to take the time to clearly explain any out of pocket treatment costs and help you budget effectively before beginning treatment. Our goal is to make sure you never have any unpleasant financial surprises. If you want to learn more about your specific dental insurance coverage in our San Antonio dentistry office, give our team a call today. Skilled dentist, Christopher J. Holland, DDS, and his dedicated dentistry team look forward to helping you achieve all of your oral health and hygiene goals.

PPO VS HMO Dental Insurance Plans

Man in dental chair giving thumbs upOur San Antonio dentistry team knows that dental insurance policies can be confusing, but we work with benefit plans on a daily basis. That means we can help you demystify your policy and maximize dental insurance coverage for all of your dentistry treatments in our San Antonio dental office. The major difference you need to understand up front is between health management organization (HMO) and preferred provider organization (PPO) plans. Most HMO plans have lower monthly payments (premiums), but they often place very strict restrictions on what dental offices you can visit and what dentistry treatments you can receive. PPO plans have slightly higher monthly premiums, but they are built around offering patients the flexibility to choose their dental offices and treatments. If you have an HMO dental plan, we are unfortunately not able to file claims for your benefits, but please don’t hesitate to call our office if you want to learn more about the insurance providers we work with. We’re here to help.

In-Network VS Out of Network Dental Insurance

Smiling woman talking to dentist and assistantHMO plan networks are very strict. If you have an HMO insurance plan, you have to visit an in-network dentist to receive coverage. Unfortunately, we are not in-network with HMO dental benefit plans. If you have a PPO dental insurance policy, we will be happy to process and file claims for patients who have both in-network and out of network policies. PPO plan networks work a little differently than HMO plans. In-network dental offices with PPO plans agree to treatment pricing that falls within a range they consider to be fair and average. As long as treatments fall within this range, the insurer provides a specified percentage of the cost of care, and the patient will pay the remaining part of the treatment cost. If you choose to visit a dentist who is not in-network with your insurance plan, you will still receive the percentage of coverage for your insurer’s fair pricing. If the dentist charges a fee that is higher than that considered average by the insurer, you will need to pay the difference in cost in addition to your out of pocket percentage of the treatment price. In most cases, the difference in pricing will be minimal, but please don’t hesitate to ask about any variation in cost if you are a patient using out of network dental benefits in our office. We are happy to provide in-network coverage for most PPO plans, including:

Services Covered by Dental Insurance

Dental benefits on computer screen

Every dental insurance plan represents a unique contract by insurers, individual patients, and often their employers. However, the majority of PPO benefit plans offer the following coverage:

  • Preventive dentistry – 80 to 100% of cost covered by benefit providers
  • Restorative dentistry – 50 to 80% of cost covered by benefit providers
  • Orthodontics – 25 to 75% of cost covered by benefit providers when elected by the patient and/or employer

Maximizing Your Dental Benefits

The easiest way to maximize your dental insurance coverage for any plan is to visit our office every six months for a checkup. These regular preventive appointments are typically covered completely by benefit plans, and they allow us to partner with you to keep your smile healthy, avoiding more advanced oral health concerns.

Our Payment & Financing Options

As part of our commitment to helping patients fit the costs of dental care into their budgets, we are happy to provide numerous payment and financing options. At the time of service, we ask that patients pay for the out of pocket percentage of treatment cost in cash, check, or credit. Whenever possible, we will split payment between visits for patients whose treatment requires more than one appointment. We also offer discounts for cash payment upfront and a 10% treatment discount for uninsured seniors. If you’re in need of advanced treatments that can be postponed, we’re happy to accept prepayment. This allows patients to provide small payments for treatments over several weeks or months leading up to the procedure. For patients who want to finance their dental care, we are happy to work with CareCredit and Citi Health Card. Orthodontic patients may also want to look into OrthoBanc financing plans. Whatever your dental care needs and budget, the New Image Dental team is here to help you find a financial plan that works for you.