Getting the dental care you and your loved ones need shouldn’t break your monthly budget. At Los
Gatos Dental Group, we are dedicated to making dentistry affordable for everyone. Our knowledgeable team
members are happy to process and file dental insurance claims to help our patients minimize their
out-of-pocket treatment costs. Our team of experts works with dental plans on a daily basis, and we know
how to make the most of your available insurance coverage. If you have questions, please don’t
hesitate to contact our friendly Los Gatos team. We will be happy to review your policy, answer your
questions, and partner with you to keep the cost of dental care within your budget.
How Dental Insurance Works
Every dental insurance plan is a unique contract between you, an insurer, and your employer (in some
cases). Each plan requires the payment of a monthly premium in exchange for your insurer providing
coverage for a percentage of specific dentistry services. While individual insurance plans vary,
most providers offer the following coverage:
100% preventive care covered
Minor restorative care around 70%-80% covered
Major restorative care around 50%
What is the Difference Between Dental & Medical Insurance?
Many dental patients want to know why their medical insurance seems to cover so much more than their
dental benefits. We remind patients that they pay significantly higher fees for their medical
insurance than they do for dental benefits. Apart from the higher cost of medical coverage, the main
difference between the two forms of insurance is what they cover.
Dental benefit plans are focused on prevention. The majority of oral health concerns can be
prevented with thorough at-home care and dental appointments twice a year. For this reason, most
dental benefit policies offer 100% coverage for preventive dental checkups twice a year. Conversely,
medical insurance provides the greatest amount of coverage for treatments to address chronic
illnesses and medical emergencies.
In-Network VS Out of Network Dentistry
When you’re looking for a dental office, you’ll want to find out whether the dental
office is in-network or out of network with your insurance provider. One of the many benefits of
dental insurance coverage is that it allows you to choose the right dental office to meet your oral
health care needs and still receive insurance coverage.
In-Network Coverage
When a dental office chooses to become an in-network provider with specific insurers,
they agree to charge fees that fall within the insurance plan’s set pricing. In
most cases, this pricing is significantly discounted from local average service fees.
When you visit an in-network dentist, you can be sure that you will only have to pay the
out-of-pocket percentage of the cost of dental care.
Out-of-Network Coverage
If you have a PPO dental benefit plan through an insurance provider, we’ll be
happy to process and file your insurance claims. In most cases, our affordable pricing
will fall within your plan’s set treatment maximums. We work with dental benefits
on a daily basis, and our knowledgeable team members will do their utmost to keep your
out-of-pocket treatment costs to a minimum.