Santa Claus Family Dentistry

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Understanding your Coverage

Understanding your Coverage

It’s important for every insured to understand that their insurance plan is a contract between them and their dental insurance provider. Read below for more information about dental insurance and the plans we accept.

Dental Insurance

Dental Insurance

what it is and what it isn’t

While each insured individual has a right to the benefits that are available through their insurance provider, those benefits have little to do with what is happening inside their mouth. Dental insurance is simply a method of payment, not a method of treatment. As your doctor and your provider for dental and oral hygiene care, I cannot and will not allow your insurance plan to restrict me with regard to any treatment you may need. Please be aware that your insurance benefits may differ greatly from the treatment that you actually need. While not required to do so, Santa Claus Family Dentistry provides the courtesy of filing your claim for services rendered with your insurance carrier.

It is your responsibility to provide us with the correct information to do so. While every plan is different, we find the majority of dental insurance plans normally cover a maximum of $500 to $1,000 per year for dental and oral care and maintenance. The majority of these plans have a yearly deductible, and they normally cover at least 80% of fees charged for one set of X-rays per year plus two professional exams and cleanings per year. Any further treatment deemed medically necessary for your dental and oral health (restorations, root canals, extractions, crowns, bridges, dentures, periodontal care, etc.) is normally covered at the rate of approximately 50%, depending upon your particular plan and the benefits it provides. That translates into your insurance provider paying a portion of your fee with you being responsible for any portion not covered by your insurance plan.

For more information regarding the benefits extended by your dental plan, contact your employer’s benefits coordinator or contact your insurance company directly. Please be advised that you are responsible for payment of all services rendered whether or not those services are covered by a dental insurance plan. All co-payments are due and payable at the time of service. Santa Claus Family Dentistry accepts payment by cash, check, Visa and MasterCard.

MEDICAID Subscribers

MEDICAID Subscribers

Santa Claus Family Dentistry will accept and file Medicaid/Hoosier Healthwise claims only for those individuals under the age of 18. Individuals who are covered by Medicaid/Hoosier Healthwise and are the age of 18 and older, must seek a practice that accepts their Medicaid.

Our Providers

Our Providers

While we file claims with all dental insurance plans, Santa Claus Family Dentistry is a participating provider for Delta Dental Premier, Dental Health Options, Anthem Blue 300 and Anthem Blue 200. As participating providers for these particular dental plans, we are contracted to accept the fees agreed upon within those contracts and other than your deductible, the insured will not be charged for any portion of our fees not covered within the terms of those contracts. If your dental insurance provider is not one of the providers mentioned above, you are responsible for any and all fees not covered and reimbursed by your dental plan.