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Things to Consider with an Out-of-Network Dentist

September 27, 2024

Filed under: Uncategorized — newsmiledental @ 1:45 am

Young woman speaking with dentistDental insurance is an investment in reduced costs for the services you need to keep your mouth healthy. Your premiums for your insurance give you access to a nationwide network of dental professionals. Every insurance policy differs, but most providers recommend choosing an in-network dentist. You can still use your insurance benefits at an out-of-network provider, but there are a few things you should know before scheduling an appointment.

How Dental Insurance Works

Dental insurance focuses on prevention to stop common oral health issues from occurring. This helps you avoid needing costly treatments later while also preventing tooth loss. Researchers have found that $1 of preventive care can save up to $50 on emergency and restorative fees. Your dental insurance allows you to visit your dentist every 6 months for a cleaning and checkup. 100% of the costs for preventive dentistry are covered for a co-payment.

If your dentist finds anything concerning, your dental insurance will pay some of the expenses for medically necessary procedures, like gum disease treatment, fillings, or dental crowns. After meeting your annual deductible, you can use your yearly allowance to lower the amount you will pay to restore your dental health.

In-Network VS Out-of-Network Dentist

Most dental insurance recommends choosing dentists that are in-network to benefit from more coverage. Dental insurance providers have pre-negotiated rates with preferred dental practices for select services to limit your out-of-pocket expenses.

You can still use your dental insurance at an out-of-network practice, but you may pay more out-of-pocket. Your benefits will still cover common treatments, but at a much lower rate.

Use It Before You Lose It

Your dental insurance benefits do not last forever. They will reset at the end of the year. You will lose anything you have not used because nothing will carry over. You aren’t reimbursed for your premiums or deductibles. With less than 3% of Americans meeting or exceeding their annual limits, billions of dollars are lost each year in unused dental benefits.

Whether you choose an in-network or out-of-network dentist, they will work on your behalf with your dental insurance to maximize your coverage. They will explain how your benefits are being used to pay for your services and your payment options for any remaining balance. You can achieve optimal oral health without spending your life’s savings, thanks to your dental insurance.

About Dr. Gilberto Lopez

Dr. Lopez has over 30 years of experience in dentistry. He earned his dental degree from the University of Arkansas at Fort Smith and has regularly continued his education to provide the most up-to-date solutions in dentistry. Dr. Lopez accepts dental insurance to keep a healthy smile affordable for everyone. Request an appointment through his website or call his office at (479) 888-7802.

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