Fremont Dentist Dr. Jaspreet Harika accepts most major Dental insurance plans and our experienced staff works diligently to maximize your insurance benefits.
Qualifying patients can also avail excellent financing options. We accept Care Credit and provide financing through Springstone. NO INTEREST – upto 18 months
There is a large number of Insurance plans available. Here are some of the major insurance carriers that we accept. We accept many more
- Blue Cross
- Blue Shield of CA
- Delta Dental
- First Dental Health
- Principal financial
- Sun Life Financial
- United Concordia
- United Healthcare
Having dental insurance can make it easier to get the dental care you need. Your dental coverage is usually based on how much your employer pays into the plan. The coverage is not based on what you need or what your dentist recommends.
How Dental Insurance Plans Work
Most dental plans are a contract between your employer and a dental insurance company. Your employer and the dental insurance company agree on the amount your plan pays and what procedures are covered. Often, you may have a dental care need that is not covered by your plan. The part of the bill not covered by your insurance is your responsibility. If you are not satisfied with the coverage provided by your dental insurance, let your employer know.
Role of your Dental Office
The dentist’s main goal is to help you take good care of your teeth. Most dental offices will be able to contact your dental insurance to check the benefits provided by your plan.
Many offices will file claims with your dental insurance as a service to you.
Common limitations and clauses found in dental insurance plans
This is the largest dollar amount a dental plan will pay during the year. You are expected to pay copayments and any costs above the annual maximum. If the annual maximum of your plan is too low to meet your needs, ask your employer to look into plans with higher annual maximums.
Plan Frequency Limitations
A dental plan may limit the number of times it will pay for certain treatment. Some patients may need treatment more often to maintain good oral health. For example, a plan might pay for teeth cleaning only twice a year even though the patient needs a cleaning four times a year. Make treatment decisions based on what’s best for your health, not just what is covered by your plan
A dental insurance plan may not cover conditions that existed before you enrolled in the plan. For example, benefits will not be paid for replacing a tooth that was missing before the effective date of coverage. Even though your plan may not cover certain conditions, you may still need treatment to keep your mouth healthy.
Some dental insurance plans contain a waiting period. It is the length of time your policy should be in force before your benefits begin. Different procedures might have different length of waiting period. For Example, if your plan contains a waiting period of six months on fillings and 12 months on root canals. It means your dental insurance will not pay for your fillings if they are done within six months of starting the plan. Similarly your dental insurance will not pay for root canal treatment if it is done within the twelve months of starting the plan.
Not Dentally Necessary
Many dental plans state that only procedures that are medically or dentally necessary will be covered. If the claim is denied, it does not mean that the services were not necessary. Treatment decisions should be made by you and your dentist.
Claims bundling is when two different dental procedures are combined by the insurance company into one procedure. This may reduce your benefit.
Some dental insurance plans change the procedure code to a less complex or lower cost procedure than were reported by the dental office.
Least Expensive Alternative Treatment (LEAT)
Your plan might have a LEAT clause. That means if there is more than one way to treat a condition, the plan will pay for the least expensive alternative. However, the least expensive option might not always be the best. For example, your dentist might recommend a dental implant for you, but the plan may only cover partial denture. You should talk with your dentist about the best treatment option for you.
Please call us at 510.284.2511 and talk to one of our qualified staff members.
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Dr. Jaspreet Harika is an experienced fremont dentist serving Fremont, Newark, Union City, Hayward, Milpitas and surrounding areas. serving zip code 94536, 94538, 94539, 94541, 94542, 94555, 94560, 94587, 95035, and beyond.