Dental Insurance

Because each insurance plan is unique, dental insurance can be hard to understand and navigate. That’s why your friendly and knowledgeable team at The Smilist Dental Medford is here to help. You can always contact us if you have questions about your particular plan, but here are some of the basic facts you should know about dental insurance.

Dental Insurance 101

Each dental plan is different, even when it’s within the same company such as Delta Dental or Metlife for example. Here are some basic things you can expect from your plan:

• There is a maximum amount that your plan will pay for benefits in a given year. This typically ranges from $1000 to $2000.
• Most plans run on a calendar year from January to December.
• Your plan may have a deductible that that has to be met before major procedures can be done. It is typically in the range of $50 to $150.
• Most plans will cover most if not all of the cost of preventative care appointments. This means that there is very little, or no out-of-pocket cost to you when you come in for your six month cleaning and checkups.
• Restorative treatment is covered at a percentage leaving you with an out-of-pocket portion to pay.

In Network vs Out of Network

Your dental plan has a network of dentists that participate with it. The insurance companies that The Smilist Dental Medford participates with are:

• Aetna PPO
• Aetna Access Plan (discount plan)
• Ameritas
• Assurant
• BlueCross Blue Shield
• Brown & Brown (aka Fitzharris)
• Careington 500 Series
• Cigna Access Plan (discount plan)
• Cigna PPO
• CSEA
• DDS (Building Trades Welfare Plan) *Associates only
• Dearborn
• Delta Dental PPO/Premier
• Dental Network of America (DNOA)
• Dentemax
• Dentegra
• DHA (Dental Health Alliance)
• Emblem Preferred Plus
• Empire Blue Cross/Blue Shield (200/300 only/XPO)
• Fitzharris & Co.
• GEHA
• GHI/Emblem (Preferred Plus only)
• Guardian
• Guardian PPO
• Healthplex
• Horizon / Rayant
• Humana
• JJ Stanis
• Liberty Plan (Guardian Fee Schedule)
• Maverest
• Metlife
• Physicians Mutual
• Principal
• SIDS
• Suffolk County Municipal Employees
• United Concordia (not Community Plan or Tri-Care)
• United Healthcare PPO (not Community Plan)

It’s important to note that if you don’t see your insurance company listed here, it does not mean that you can’t see our dentists, it simply means that there may be different coverage with an out of network provider. With many plans, there is minimal difference between in network and out of network coverage, and we are happy to research your plan to determine your  specific coverage.

Do You Have Questions?

At The Smilist Dental Medford we are proud to provide our patients with an exceptional experience each time they visit. This includes helping you understand your dental insurance benefits so you can maximize them and get the treatment you need and deserve. If you have questions about how your plan works, what is covered, or if we are in your network, never hesitate to call us. We are here to help you!