Do you accept my insurance?

That’s an interesting question. It depends. Maybe it’d be easier to answer if the question was rephrased: Does your insurance company accept your dental practice?

Dental insurance companies usually provide two kinds of benefits for its members: In-network and out-of-network benefits.

In-network refers to dental practices that sign up to be network providers with a specific insurance company. Terms of service are established that include, among other things, adhering to a fee schedule set by the insurance company. A contract is signed, and the dental practice becomes part of that insurance company’s network.

Out-of-network refers to everybody else.

So, if you go to a dentist that is in your insurance company’s network, things are pretty easy. Not only do you know what benefits to expect, you know that the dentist and the insurance company are on the same page as far as price.

If you go to a dentist that is out of the insurance company’s network, things are different. First, you are responsible for the difference, if any, between what the dental practice charges and what the insurance company will pay. Second, it’s possible, that the percentage of coverage the insurance will provide for any particular procedure could be lower. Finally, an insurance company might not provide ANY out-of-network benefits.

So, to answer the first question: Yes, we accept most dental insurances, even ones whose network we are not enrolled in, but, to answer the second question, the insurance company might not accept us.

What can you do? Check with your insurance company to see which dentists are in-network. If your dentist is out-of-network, and you want to keep that dentist, request from the insurance company a breakdown of out-of-network benefits. The difference between in-network and out-of-network might be negligible.