In and Out of Network Dental Insurance Questions
In your efforts to save money and also keep your current dentist, have you ever had a conversation like the following:
You: Hi, I just have a quick question. Do you accept Delta Dental insurance plans…?
Your dentist’s receptionist: Yes we do.
You: Okay, thanks!
Millions of people have that exact same conversation, about Delta Dental or any number of dental plans. Like you, they probably think it means they’re going to be able to keep their current dentist and also pay the lowest rates.
However, if that’s your goal, you need to ask a different question.
The Question You Should Really Be Asking
So, if you want to keep your dentist and save money on dental care, what’s the question you should really be asking? And whom should you ask?
The best way to learn if you can keep your dentist and pay less is to ask both your dentist and the plan carrier or provider. And the question to ask is this: Is the dentist under contract as part of the specific dental insurance plan’s preferred provider network?
Learn more: 5 Things You Should Know About PPOs
We need to pay close attention to many details when it comes to insurance products. Dental insurance is no different. Some of the most common issues we hear from people have to do with the difference between in and out of network dental. How do the costs compare? Can I keep my own dentist?
And why not? Most people love their dentists. We want to do whatever it takes to remain with them if possible. So, for instance, folks will shop for dental insurance and, before buying a plan, call to ask if their dentist “accepts” the plan.
Alert: This is when paying close attention to the details can make a big difference.
The truth is, dentists may accept any number of dental plans. But that doesn’t mean they are in the plans’ preferred provider groups. Being a preferred provider makes a dentist part of a plan’s official network of dentists. That’s where the term “in network” comes from. And being in network or in a plan’s preferred provider pool is the real key to helping you save money.
Why all this confusion over network dental insurance?
Dentists want to keep you and your teeth healthy. However, they tend to leave the money saving part to you and your insurance provider. After all, that’s why you have a dental plan – to help you pay. Of course, dentists are running a business, as well, and contracting to be included in various carriers’ preferred provider pools is one of the ways they attract new patients and keep established ones happy.
…being in network or in a plan’s preferred provider pool is the real key to helping you save money.
Getting into the network requires your dentist to sign a contract with the plan provider. They agree to charge the plan’s lower rates for their dental work. Your dentist cannot be a part of every provider’s network. Like you, they have to choose carefully which plans to sign contracts with based on many, sometimes conflicting, considerations.
When you ask the dentist or her receptionist if they “accept” a dental plan, they answer you in an honest and efficient way. They don’t waste time probing to see whether you really understand the question you’ve asked. But the truth is, you haven’t really asked whether using a certain plan will help you remain under their care and also save some money on dental work. That is not the question they hear.
Until they’ve signed a contract to join the plan’s preferred provider network, they may in fact accept the plan but still have every right to charge higher rates than an in-network dentist would charge for the work they do. And when they do, you, not the plan, will have to pay the difference in cost.
Shop Your Dental Options Like a Pro
It’s a classic case of the heart vs. the head or emotions vs. logic. No one wants to pay more than needed for dental care. And no one wants to leave the dentist they’ve grown to know and trust just to save a few dollars.
So remember, the question to ask is this: Is the dentist under contract as part of the specific dental insurance plan’s preferred provider network? Be sure you ask your dentist and the plan’s carrier.
It’s a clear and unambiguous question. A simple yes or no will do. And, with confirmation of “in network” status from both your dentist and the plan carrier, you’ll be free to move forward with your dental work with confidence and then get on with something a little more interesting.
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