Office Hours:        Mon, Tues, Wed, Fri, Sat, Sun 9am-3pm                                              

(During Spring and Summer) Tues 9am-7pm

BY APPOINTMENT ONLY

                

FAQs

DENTAL INSURANCE

DO YOU TAKE MY INSURANCE?

  • We accept most major commercial insurances, such as Aetna PPO, Cigna PPO, Delta Dental, Guardian PPO, MetLife PPO, and United PPO.  
  • We do not accept NJ Medicaid, NJ Family Health, Horizon NJ Health, United Community Plan, Amerigroup, Americhoice, Healthplex, Healthfirst, any type of Horizon Blue Cross Blue Shield, or GHI.

When in doubt, call or email us to have us check, because there are so many plans with so many fine prints. We deal with these on daily basis so we can quickly find out the essential information of your plan for you in a shorter amount of time. 

 

WHY DO I HAVE TO PAY WHEN I HAVE DENTAL INSURANCE?

 

  • Dental insurance is actually not an insuirance, but a dental benefit plan.  Also, it is only a form of financeial assistance to help with the expense of dental care. 
  • Some plans require that annual deductibles is paid by you first to get the benefit of the dental insurance plan you bought.
  • Dental benefit plans usually pay 80%-100% of preventive care such as dental exams, dental x-rays, dental cleanings, and dental sealants.  However, if you have a dental problem, such as a cavity or missing teeth, your plan will only pay 50-80% of the cost.  This is called the co-insurance or co-payment for the treatment procedures.  The cost of treatment that is outstanding after your insurance company pays is still your responsibility.
  • Dental benefit plans usually have limitations such as how often  the insurance company will pay for common procedures, such as dental examination, dental x-rays, dental cleanings.  Older dental benefit plans will pay for only 2 exams, 2 x-rays, and 2 cleanings per year.  It does not mean you only need 2 exams.  There may be times where you need exams more than twice such as going to a specialist for a consultation. However, if the insurance company sees that they already paid out for two exams, they will put the responsibility of the cost of the exam entirely on you. 

WHAT IS THE DIFFERENCE BETWEEN A DISCOUNT PLAN AND DENTAL INSURANCE?

  • DISCOUNT PLANS is where pay the insurance company to get a list of their con tracted netowrk dentistis where you can get dental treatment for a lower fee. The subscriber pays for all  dental treatment, including dental exams and dental cleanings, to the dentist at the time of the visit. For those treatments that are not negotiated by the insurance company with their contracted dentist, you will be responsible for the dentist's full fee.  With discount plans, insurance company does not pay anything toward your treatment as it would if it was a true dental insurance benefit plan. 

I HAVE TWO DENTAL INSURANCES. DO I STILL HAVE T0 PAY OUT-OF-POCKET?

  • If you have two dental insurance, it does not mean you have no out-of-pocket expense.  On the contrary, you still have out-of-pocket expense 99.99% of the time after the secondary insurance pays out.  There are times when the secondary insurance will pay nothing out on your treatment but reduces your annual benefit with the secondary insurance by the amount the primary insurance paid out.

 

 

 

 

 

 

 

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