Dental Insurance
Reading dental insurance plans can be confusing, especially for first-time users. It's important to know your coverage before an appointment. To understand how dental insurance works, read on! Your employer and an insurance representative can answer questions about your plan.
Canadian Dental Care Plan (CDCP)
Argyll Dental proudly accepts the Canadian Dental Care Plan (CDCP). This implies that our patients may easily afford to receive excellent dental care. The CDCP seeks to reduce the cost of dental care so you may get the finest possible oral health care. Your smile is our first concern at Argyll Dental where our skilled staff works hard to provide you with individualized and complete dental care that meets your specific needs.
If you have secondary insurance beyond your primary coverage, let us know when you check in for your dental appointment. To invoice your secondary insurance provider successfully, we require the name of the carrier, group/plan number, ID/subscriber number, and the full name and date of birth of the secondary policyholder.
What is the patient responsible for?
Insurance coverage is an agreement between the insurance company and your employer. Dental plans vary; some cover up to 100%, while others cover only 10%. Understand your plan before appointments. Insurance may not match the current year's fee guide. Our office follows the Ontario Dental Association's annual updates. The coverage amount is separate from the dentist's role. Patients pay any unpaid co-payments and are responsible for uncovered procedures.
What is the Dental Clinic responsible for?
Your dental clinic will offer treatment options tailored to your needs, based on your dental health rather than your plan's limits. Dental estimates can be submitted to your insurance provider to inform you of expected coverage for treatment procedures.
The policyholder will get a copy of the response and should check the estimate and coverage before making an appointment. Sometimes, the insurance provider may reach out to the plan administrator for more details, particularly for procedures like crowns, implants, and Invisalign. The plan administrator will tell you to ask your dentist for this information, which the dental office will provide. It is your job to pass this information to your plan administrator.
Paying upfront vs. Paying the difference
Patients often wonder whether they need to pay for dental treatment upfront and get reimbursed by insurance or just pay the difference. This depends on the insurance plan. Some plans allow paying the difference, while others require upfront payment. Our office accepts assignment of benefits, unlike some dental practices. If your plan allows it, our reception team can help submit your dental claims, and we will collect the portion not covered.
Primary and secondary dental insurance
Some patients have two insurance plans. Please tell us if you're covered by your partner's plan along with your own. If you're a student (over 18) under a parent's plan, let us know that too, and include the name of your college or university. We'll also need to know if you're a full-time or part-time student. After your appointment, we'll submit a claim to your primary insurance. If this insurance covers less than 100% of the services, we'll send the claim to the secondary insurance. The secondary insurance will review the primary coverage before making a decision. You are responsible for any remaining balance not covered by both plans.
We are here to help!
We aim to provide excellent dental care. Dental benefits help support your treatment choices, but they are not meant to guarantee the best care. Keep in mind that a dental insurance plan is not the same as a treatment plan. For questions about your dental coverage, contact your employer or insurance provider.