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Why Didn’t Insurance Cover the Cost of My Dental Work?

December 13, 2019
by
Dr. Dimitrios Vareldzis

Many patients are perplexed by the seeming inconsistencies of dental insurance coverage. If the policy didn’t cover the entire cost, were they being overcharged? Or was it a defect in the policy itself?

Every insurance policy is essentially the same proposition. It’s a hedge, or a cushion, against the financial impact of some event. That event may be an automobile accident or destruction of a house or serious illness—or root canal surgery. And every insurance policy is only as good as the plan purchased.

If you have auto, home or life insurance you probably know that, in general, the more expensive the plan, the better the coverage. However, since employers typically provide dental insurance as part of a wage package, patients are often in the dark about the value of the benefits.

Because most patients don’t pay dental insurance out of their own pocket, and because every policy describes its coverage, they can be lured into believing their dentistry will be completely covered. But that’s a misinterpretation of the role of insurance.

Dental insurance reimbursement is a response based on average fees submitted by average offices. Our fees are based on the actual cost of doing business in this office. With these many variables, it’s easy to see how fees and coverage rarely see eye-to-eye.

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