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Insurance Facts & Myths

Startling Fact About Dental Insurance:
1960’s average yearly maximum - $1,000
2008’s average yearly maximum - $1,000

Adjusting for inflation and cost of living, the yearly maximum should now be around $4,500.

What this means to the patient is that although it is beneficial to have insurance it will likely times not cover 100% of all treatment fees as it may have in times past. Insurance companies are in the business to make money. They make more money by paying fewer benefits and by using stalling tactics to avoid making payment at all.

The Usual, Customary, and Reasonable (UCR) Myth: It has been the experience of many dentists that often times insurance companies tell their subscribers, you the patient, that certain fees an office may be charging are above the “usual, customary, and reasonable" or UCR, rather than tell them more accurately that the insurance benefits are too low. UCR is not determined by what typical dental offices commonly charge. No survey is conducted by the insurance carrier to determine the actual fees that dentists in a particular area charge.

UCR is determined by how much your employer has paid for that particular plan. The less your company (or you) has paid for your plan the lower the amount you will receive in benefits. We are not involved with the insurance company in any way. Each insurance company will make payment according to a UCR fee schedule that has been determined by their standards.