[omr1174]

Are there any dental insurance experts out there? Why are so many procedures that are medically necessary (according to the dentists) NOT COVERED or VERY LIMITED?? For example, bonded fillings that help to hold a tooth together that requires a deep filling (as opposed to silver fillings that just fill up the hole and inevitably lead to cracks in the remaining tooth), or crown lengthening, or root canals, etc??

[ballengerb1]

Most every dental plan pays more for preventive care than restoritive care. They pay 100% for 6 month cleanings to help prevent decay. Once decay is present they pay a higher percentage for early care a small fillings like a amalgum, silver filling. If your teeth are worse than this and require a crown or articificial tooth the payment drops. The insurance companies say that we should have sought care sooner and not let things get so bad, so their coverage is at a lower percentage. Bottom line, they must make a profit to stay in business so they will always find a way to pay out les than they take in. Most plans also top out at $1400 per year.

[flossie]

That is a question you should ask the insurance company.

Plans are usually set up with the best interest of the insurance company in mind. They offer different packages for employers to offer their employees.

Dental insurance is a "benefit" and is not meant to cover the entire cost of everything. If you have a plan that does that, consider yourself extremely lucky!

Dental insurance is an extremely costly benefit to offer and over the past years I have seen many companies reduce coverage when contracts are negotiated.

You are lucky to have ANY dental coverage, there are many who pay for all necessary dental work out of their pockets regularly. It all depends on how much you appreciate your dental health.

If you broke your arm and your benefits only covered a splint when for the best healing of your arm you require a full plaster cast which was going to cost a couple of hundred dollars more, what would you do? I bet you'd pay the extra.

[Fr_Chuck]

There are dozens if not 100's of types of plans, And each have a schedule of benefits they will pay for.

And most dental insurance costs so much, normally it is not even cost effective unless you are going to have 4 or 5 hundred dollars of dental work every year.

And as noted most people don't have any dental insurance now adays.

But my dentist and I have a relationship, if insurance is not paying for it, or even if it is, we talk what it is going to cost me before we do it. And I say NO, NO NO to a lot of treatments I can't afford and make them do it other ways that I can afford.