Insurance & FinancingPatient Resources
Insurance Policies And FAQs
What does Dual Insurance mean?
“Dual Insurance” refers to a patient with multiple dental benefits plan.
What is an Effective Date
Used to define the date that benefits begin for a plan enrollee.
Are there coverage limits?
- A limit on the number of exams, cleanings and bitewing x-rays that will be covered by the plan each year.
A limit on how often a full series of x-rays will be
- covered by the plan each year. Time limits on the replacement of crowns, prosthetics (bridges, dentures, and implants).
- A waiting period, or even an exclusion, may apply for the replacement of the teeth lost prior to coverage. Many dental plans include an alternate benefit provision. This means that if your dentist proposes a dental service, the plan may cover another lower-cost dental service that provides a professionally acceptable result for the issue being treated. You have the choice to receive the originally recommended service, which will increase your out-of-pocket costs. For example, under an alternate benefit provision, a plan may cover a:
- Silver filling (amalgam) instead of the higher-cost composite resin (tooth-colored) filling on a back tooth.
- Large filling (silver or white material) on a tooth instead of a full coverage crown. If you choose to have the “white” filling, you will pay the difference between the covered silver filling and the cost of the composite filling.
Dental plans may not cover every dental service that may be suggested by your dentist. For example, some plans may not cover implants. In addition, services for strictly cosmetic reasons, such as teeth whitening, are rarely covered by dental insurance. However, discounts for these services may be available at your dental office. The Office manager or Treatment Coordinator will be happy to discuss available discounts with you.
Annual and Lifetime maximums
An “annual maximum” provision is included in the majority of dental plans and places a total dollar cap (maximum) on the amount of benefits to be paid out to an insured member during a single plan year. Once the plan’s maximum (e.g. $1,000 or $1,500) is reached, the plan will not make any payments until the first day of the next plan year. A yearly maximum could run on calendar year (January to December), or on a fiscal year, depending on the dental insurance company.
Lifetime maximum refers to
The cumulative dollar amount a plan will pay for dental care incurred by an individual enrollee or family (under a family plan). Lifetime maximums apply to specific services such as orthodontic treatment.
Do you accept my insurance plan?
Suave Dental accepts most employer group dental PPO plans. These include but are not limited to: Delta Dental, Aetna, Cigna, MetLife, Premier Access, UFCW, and Blue Cross. We also accept State insurance programs such as Medi-Cal. Please call your local Suave Dental office for more information. And remember, it is important that you understand your plan and what it covers. If possible, please bring a copy of your insurance card and ID to your first appointment.
For your convenience, Suave Dental accepts cash, checks, and all major credit cards: Visa, MasterCard, Discover and American Express. Please let us know if you have a flexible spending account (FSA) through your employer for medical expenses. Your Dental treatment fees can be applied to your FSA.
Patients who pay in advance for their entire treatment may be eligible for a discount. The Office Manager will provide you with details on the types of discounts available. (Note: Discounts apply only to treatment services, excluding initial examination, prophylaxis (general cleaning) and consultations. Discounts cannot be combined with any other offers).
We want to thank you for choosing Suave Dental. If you have any questions or concerns regarding our financial guidelines, we encourage you to contact us at 888-607-8283 . You can also visit any of our Suave Dental Centers and one of our office Associates will be happy to assist you.
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