(408) 720-0900   •   (877) 9 Dental 25x25

Nasser Antonious, DDS, MAGD, FICOI
Master of the Academy of General Dentistry
Fellow of the International Congress of Oral Implantologists

Campbell Preferred Provider-PPO Insurance Dentist
Sunnyvale Dentistry Home >> Dental Patient Resources >> The Right Dental Insurance for You    

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Understand Your Dental Insurance
Preferred Provider (PPO) Dental Insurance
The Right Dental Insurance For You
Five Things You Should Know When Choosing A Dental Insurance Plan
Selecting An Affordable Dental Plan For Your Family





The Right Dental Insurance for You

People in the US are often faced with a lot of questions regarding dental insurance. Is dental insurance worth the cost? Will dental insurance cover every dental procedure? Should one even bother applying for dental insurance?

To answer these questions, we’ve done some prolific research on the ins and outs of dental insurance. And to tell you frankly, dental insurance is not rocket science. It just takes patience to get through the important details encapsulating this matter.

Dental insurance, in its simplest form, is the full or partial coverage of fees associated with dental care. Dental insurance comes in many forms, like for example, individual dental insurance. Households often apply for family dental insurance and companies apply group dental insurance for their employees. The fees associated with the different insurance plans are reduced when the numbers of members applying for the insurance increase.

Dental insurance can be purchased directly from the dental insurance company, a broker or an online reseller of dental insurance. You can purchase dental insurance at a cheaper price when the company you work for buys it for you. Regardless of whether they give free dental insurance to their employees, you should let them be the one to apply the insurance for you, even if you have to pay for it.

Dental insurance plans vary in coverage and in pricing. The rule of the thumb is: The more the coverage, the more you have to pay. A majority of dental insurance providers have a maximum allowable coverage for individual dental procedures. The average yearly maximum allowable dental insurance coverage amounts to $1,000, depending on the provider. Depending on the plan, one might be compelled to follow a calendar year (January to December) or a fiscal year for the insurance coverage. An important thing to consider is that the benefit coverage does not roll over, meaning if you didn’t use the $1,000 coverage this year, it won’t accumulate to next year’s coverage, so it’s important to make the most out of your insurance plan.
A widely talked-about fine line of dental insurance in the United States is the In/Out of Network Dentists. Most insurance companies will only cover your dental fees if you undergo the dental treatment/procedure under the administration of their affiliate dentists, or In-Network Dentists. These In-Network Dentists are sponsored by the dental insurance provider. You can, however, go to an Out-of-Network Dentist, but the insurance will only a cover a bare minimum of the fees – and not all dental insurance providers will agree to cover Out-of-Network dentist treatments/procedures. It is imperative that the insurance-seeker should first make inquiries if the local dentist is sponsored by the dental insurance provider.

There are three (3) widely-acknowledged types of dental insurance:
Each dental insurance company has its (Usual, Customary and Reasonable) fee guide, which will give you detailed information on what types of treatments and procedures they cover and what is the maximum coverage for every procedure. If the cost of the dental procedure is higher than the fee coverage posted on the UCR fee guide, you will have to pay the balance out of your own pocket. That being said, it is also imperative to collate the different UCR fee guides of different dental insurance companies so you know what your best pick is.
Dental insurance companies segregate the different types of dental procedures and subcategorize them as:

1. Preventative
- checkups
- routine cleanings
- x-rays
- dental sealant treatments
- fluoride treatments

2. Basic/Restorative
- dental fillings
- tooth extractions
- root canals
-gum treatment
3. Major
- crowns
- bridges
- dentures
- partials
- surgical extractions
- dental implants

Some insurance providers only provide coverage for preventative and basic/restorative procedures, while others have waiting periods(that may reach up to 12 months) for certain dental procedures (meaning you will to pay for the procedure first and wait 12 months before being eligible for reimbursement). So if the dental insurance provider you have looks shady, it’s high time you looked for another insurance provider.

And if you already have a missing tooth that you intend to be replaced with the help dental insurance, chances are your request will be denied, since 90% of dental insurance providers do not cover missing tooth replacements for teeth that have been previously lost before the insurance was approved And there’s no way to outsmart them either, since they are going to take X-rays of you and have a snapshot of your previous dental condition before approving your application.

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back to Previous Page
Understand Your Dental Insurance
Preferred Provider (PPO) Dental Insurance
The Right Dental Insurance For You
Five Things You Should Know When Choosing A Dental Insurance Plan
Selecting An Affordable Dental Plan For Your Family

Campbell PPO Insurance Dentist-Preferred Provider Dentist
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Nasser Antonious DDS is licensed as a general dentist in California. Sunnyvale Dental Care established since 1995
Sunnyvale dentist, Nasser Antonious DDS welcomes new patients from all areas including Sunnyvale, Mountain View, Santa Clara, Cupertino, Campbell, San Jose, Saratoga, Los Altos, and Los Gatos
General dentist, Preventive dentist, Cosmetic dentist, Invisalign dentist, Implant dentist, Children dentist, Sedation dentist

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