Important Insurance Information
We, at Mebane Pediatric Dentistry, want to make your child’s visit as convenient as possible. As a courtesy to our patients, we help file most major dental insurance plans and even offer a 10% discount for our patients who will not be filing insurance with us! Our office is in-network with select insurance plans. Please call our office for details about which insurance companies we are in-network with!
Pediatric Dental Insurance
Each time a patient provides us with their dental insurance information we will complete a complimentary benefit check for you! We want to ensure that your child is eligible for services before they are performed and we want to do our best in determining what insurance will cover. In contacting your dental insurance, we want to obtain the most accurate details, pertinent to your child’s treatment needs. We will obtain a complete dental breakdown provided to us by your insurance company however, we do rely on the you, the subscriber to be the expert of your own insurance plan.
How does the Federal Healthcare Law effect my child’s dental coverage?
Before the federal healthcare law took effect, medical and dental plans were offered as separate products. This fact still holds true but, now medical plans offered through the Federal Healthcare law have plans that offer embedded pediatric dental. Because these plans are embedded into the medical policy, the dental portion of the plan follows medical plan guidelines. What we have learned, is that for the most part a higher medical deductible will apply to dental services that apply to the deductible.
What is a deductible?
A deductible is the fee an insurance expects the patient to pay out of pocket before services are covered at the delegated coinsurance. For example, if the plan holds a $50.00 deductible and the service rendered applies to the deductible, the patient will be responsible for the fee of that procedure until it meets $50.00. To expand, an x-ray may apply to the deductible with a fee of $22.00. The patient will be expected to pay $22.00 with $28.00 remaining to meet the deductible. After the $28.00 is met (from a remaining service completed that applies to the deductible) the service will be covered at the full coinsurance percentage mandated by the plan.
What is an annual maximum?
An annual maximum is the max-allowable amount that your insurance will pay out for each person per year. Once this has been met and/or exceeded, the patient is held fully responsible for any remaining charges for services rendered.