A Word From Accounts Manager Alyssa Vigus: Why Doesn’t My Dental Insurance Pay for This?
USUAL, CUSTOMARY & REASONABLE CHARGES
These dental charges are the maximum amounts that will be covered by the dental insurance plan. It may sound like the standard rate for dental care; but it isn’t. This is misleading for several reasons:
- UCR charges often don’t reflect what dentists “usually” charge in a given area.
- Insurance companies can set whatever they want for UCR charges. They are NOT required to match actual fees charged by dentists.
- Insurance companies are NOT required to say how they set up their UCR rates. Each company has its own formula.
COORDINATION OF DENTAL BENEFITS:
This applies to patients covered by more than one dental plan. Insurance companies typically want to know if you have other coverage; so they can coordinate your benefits. The benefits from both companies should not add up to more than the total charges from your dental visit. Although you may have two or more dental benefit plans, there is no guarantee that either of the two or more plans will pay for your services.
The reality of the answer to the question is that insurance companies do NOT cover all dental expenses! Those who have individual plans or acquire a dental plan through their employer should know and fully comprehend their dental plan. Your employer has made an agreement through your dental insurance company to pay for part of your treatment, but not all of it. If you have any questions about your plan or would like more information on what your plan covers, please contact me at our dental office here in Columbia, MD.