Fremont Dentist Dr. Jaspreet Harika accepts most major ppo Dental insurance plans and our highly trained staff works diligently, to help our patients use their dental insurance benefits optimally.
Please call at 510.284.2511 to check if we accept your ppo dental insurance plan. There is a good chance that we do !
Some of the major insurance carriers that we accept ppo plans from, are listed below. 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 and more affordable to get the dental care you need. It is important to note that your dental coverage is usually based on how much your employer pays into the plan. The coverage is not based on what kind of treatment you need or what your dentist recommends.
How Dental Insurance Plans Work
Most dental insurance plans are a contract between your employer and a dental insurance company. Your employer and the dental insurance company agrees on the amount your plan pays for 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 plan, please let your employer know so that your employer can pick the dental insurance plan that works best for the employees.
Role of your Dental Office
The dentist’s main goal is to help you take good care of your teeth and make sure that your mouth is healthy. Our dental office staff will contact your dental insurance to check the benefits provided by your plan. We will share this information with you at the time of your appointment, so that you know exactly what the insurance coverage is, before the treatment is done. Our staff will also file claims with your dental insurance, on your behalf, as a free service to you.
Some examples of coverage under typical PPO plan are listed below (Benefits covered under your plan might be different)
- Oral Exams and X-Rays covered at 100%
- Teeth Cleaning 2 times per year covered at 100%
- Tooth Fillings covered at 80%
- Root Canals Covered at 80%
- Gum Treatment/Deep Cleaning Covered at 80%
- Crowns/Bridges/Dentures Covered at 50%
- Tooth Extraction Covered at 50%
- Deductible $50
- There could be an Orthodontics coverage, for braces etc, with a lifetime maximum amount.
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.
Call us at 510.284.2511 to setup an appointment with Dr. Jaspreet Harika DDS – Fremont Dentist if you are looking for an Experienced and Gentle Dentist, for yourself or your family, in Fremont, Newark CA, Union City or surrounding areas. Or you can request an appointment now, by clicking here and we will send you a confirmation by email or phone.
Please visit the New Patients page for useful information about online forms, financing options and other items, to help you with your first visit to our dental office in Newark CA. Lastly, don’t forget to check our online PROMOTIONS. Since, we do have promotions for insurance patients as well!
Our patients come from all major employers in Fremont, like Fremont Unified School District, Tesla, Lam Research Corporation, Thermo Fisher Scientific, Palo Alto Medical Foundation, Washington Hospital, Seagate, Western Digital, Synnex and from Newark such as Newark Unified School District, Logitech, Amazon, WorldPac, Full Bloom Baking Company, Risk Management Solutions, Smar Modular Technologies, Morpho Detection, Carhill Salt, City Of Newark, Valassis, Wellsfargo and other major employers like Facebook, Oracle, Intuit, NetApp, Symantec, Genentech, workday etc from across the bay area.
We look forward to seeing you soon!
serving zip code 94536, 94538, 94539, 94555, 94560, 94587 and beyond.