Understanding Your Dental Insurance

Posted by DrSimmons | Filed under

                    Understanding Your Dental Insurance

 There are currently  two types of insurance: PPO or Indemnity plans, where you can see any Dr of your choice and  HMO plans which assign you a Dr or practice they contract with.

 Most dental insurance plans carry a yearly maximum benefit of $1,000.00-$2,000.00 for you to use each calendar year or contract period.  Each carries an annual deductible ranging from $50.00 (the most common amount) to $150 that must be met before the insurance pays.  

 Insurance companies have specific coverage rules (i.e. what they will pay) on every procedure.  Just because you have a $1000 dental insurance plan, doesn’t mean that they allow you to use it carte blanche. 

For example:

  1. Preventative/maintenance care such as exams, x-rays and, teeth cleanings, the insurance will pay 80-100% of the cost
  1. Basic care such as fillings, extractions, root canals, gum surgery, the insurance will pay 70-80% of the cost. note: -some insurance’s will only pay for amalgam fillings on your back teeth, even though the white       composite material is a stronger, more permanent filling)
  1. Major care such as crowns (caps), fixed bridges, removable dentures, implants the insurance will pay 40 – 50% of the cost.

 Choosing insurance every year is confusing.  We want to help you get the best possible care for your hard earned money.     

Below is a list of insurance plans we are contracted with as in-network PPO providers.

 Delta Dental Premiere Provider

  1. MetLife /  Metropolitan 
  2. Cigna
  3. Guardian
  4. Aetna
  5. United Concordia 
  6. DHA Assurance 
  7. Sun life Financial 

 Being a PPO provider means we provide you with the best possible care in a private room, not a clinical setting, and we guarantee the dental work we do on our patients.  We also purchase the best materials and supplies available to provide all our patients with quality, long lasting, dental treatment.  

The bottom line is, if you can choose your own dentist, then why not choose the dental family that has been at the same location for over 37 years?  Dentists who have your best interests at heart. We thank you for allowing us to care for you and your family.

 Please call us if you have any questions.


 Dr. Gerald and Michael Simmons

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