Question: I need to find a family dental plan where we can all go to the dentist whenever we need to and pay the dental office bills after the dental insurance company pays their part before making us pay our share of the cost.

In the past, we had plans to pay the dentist upfront for the total cost of our dental services and wait for the insurance company to refund us. In this day and age, who can afford to do that? I know we can not. 

Those types of dental insurance plans keep us from going to the dentist, and at that point, I do not see paying $120 a month for a dental insurance plan we do not even use because we can not pay upfront for dental services. What options are left for us that would be more affordable?

Reply: Welcome! I hope you are doing well today. I want to discuss dental insurance plans and how claims are processed. I can understand why the claims process can be upsetting, particularly regarding how claims are paid. Let me assure you that you are not alone. Many people have questions about dental insurance plans and how they work.

Based on what you have told me, you have either a dental PPO or an Indemnity dental insurance plan. If you like the plan benefits and coverages overall and it is just about how claims are paid, consider talking to your dentist. With dental PPO and Indemnity plans, the payment process and how the dentist gets paid is really up to the dental office. It does not typically come from your insurance company.

The dentist can choose to submit the claim and get paid by the insurance company before billing out any remaining balances to their patient. In the past, many dental offices processed claims that way. However, sadly, many patients would fail to pay their part, and then the dentist’s office would have to chase them down for payment. This is why many dental offices have started billing their patients in full and making them file claims to the insurance company to get paid back (refunded) the part due them.

Some dental offices charge you what they think your part of the cost would be based on your policy coverages, then bill or credit you depending on the outcome. However, few dentists still do this, as it can still be an issue of fully getting paid for services already rendered.

Based on what we have discussed, it is not an issue with the insurance plan per se but more of knowing how your dentist is willing to file claims and how they expect you to pay for services. Therefore, if you are still facing issues with your dental insurance plan, you may need to change your dental office, not your dental insurance plan. I hope this information was helpful to you. If you have any additional questions, please do not hesitate to ask.

New York Supplement Dental Insurance plans:  I was told that you can get a supplemental dental insurance plan to help off set the cost of dental services that your main plan does not pay for.   I have a dental plan from work but the max limitation is not very high and I seem to go over the UCR fees.  Would get a supplemental dental insurance plan help me off set my max limitation and keep my cost within the UCR fees as well?

I hear that you can have two dental insurance plan working together in order to save you more money off your dental cost but I can not seem to find anything on it.  My dental office tells me they will only take one plan.  Not two.  So how do you get two plans working together and what dental offices deal with two plans.

Right now I have my dental though work but it is only a 1000 max which is not much coverages when you may need a crown or something more then a cleaning.

Supplemental dental insurance is an individual or family insurance policy purchased to cover a portion of the dental costs. Supplemental dental insurance will normally not cover the entire dental care procedure.

If you have a primary dental insurance plan that you purchased or your employer provided, the supplemental dental policy typically covers the remaining dental bill.  For example, if the dental plan policy covers half of the dental cost, the secondary or supplement dental insurance plan should cover the remaining balance of your dental procedure.

A supplement dental insurance plan may also be purchased to cover the dental charges when there are annual dental benefit plan limits or exclusions.