Question: I need to find a family dental plan where we can all go to the dentist whenever we need to and pay the dental office bills after the dental insurance company pays their part before making us pay our share of the cost.

In the past, we had plans to pay the dentist upfront for the total cost of our dental services and wait for the insurance company to refund us. In this day and age, who can afford to do that? I know we can not. 

Those types of dental insurance plans keep us from going to the dentist, and at that point, I do not see paying $120 a month for a dental insurance plan we do not even use because we can not pay upfront for dental services. What options are left for us that would be more affordable?

Reply: Welcome! I hope you are doing well today. I want to discuss dental insurance plans and how claims are processed. I can understand why the claims process can be upsetting, particularly regarding how claims are paid. Let me assure you that you are not alone. Many people have questions about dental insurance plans and how they work.

Based on what you have told me, you have either a dental PPO or an Indemnity dental insurance plan. If you like the plan benefits and coverages overall and it is just about how claims are paid, consider talking to your dentist. With dental PPO and Indemnity plans, the payment process and how the dentist gets paid is really up to the dental office. It does not typically come from your insurance company.

The dentist can choose to submit the claim and get paid by the insurance company before billing out any remaining balances to their patient. In the past, many dental offices processed claims that way. However, sadly, many patients would fail to pay their part, and then the dentist’s office would have to chase them down for payment. This is why many dental offices have started billing their patients in full and making them file claims to the insurance company to get paid back (refunded) the part due them.

Some dental offices charge you what they think your part of the cost would be based on your policy coverages, then bill or credit you depending on the outcome. However, few dentists still do this, as it can still be an issue of fully getting paid for services already rendered.

Based on what we have discussed, it is not an issue with the insurance plan per se but more of knowing how your dentist is willing to file claims and how they expect you to pay for services. Therefore, if you are still facing issues with your dental insurance plan, you may need to change your dental office, not your dental insurance plan. I hope this information was helpful to you. If you have any additional questions, please do not hesitate to ask.

Question: I have a PPO that has a waiting period for almost everything. Since I have the plan for seven months, I only have five more months until I can have significant services. When I bought the plan, I did not think waiting periods would be an issue and that I could wait them out. Now, I need a crown that will cost about $900.00. After the waiting period, the insurance company that I am with will cover 50% of the cost.

I need the crown now; are there better ideas than waiting five more months? My dentist said I should get the crown now since it will help protect my chipped tooth. Can I get the crown and file the claim after the waiting period? That way, I will at least get my $450.00 back in the five months after I file the claim. I hate spending money that my insurance company should pay out for.

Reply: I can understand your frustration with waiting for the insurance company to cover the cost of your crown. It’s good that you have consulted with your dentist and know the importance of getting the crown to protect your chipped tooth. 

Consider asking your dentist if they offer any payment plans or financing options. A payment plan could allow you to get the crown and pay for it over time rather than waiting for your insurance to kick in. 

I would advise against filing the claim after the waiting period. Most insurance companies have policies requiring claims to be filed within a specific time frame, typically within a few months of the service date. 

It’s important to understand that filing a claim for a service received during a waiting period but saying it was after could be considered insurance fraud. If someone files a claim with false information, the insurance company may deny it, revoke the policy, or even pursue legal action.

Suppose an individual receives crown treatment during the waiting period of their insurance policy and submits a claim stating that the treatment was accepted after the waiting period. In such cases, the insurance company considers this act as fraudulent. If the insurance company uncovers this false information, it will reject the claim and inquire into the policyholder’s other claims and medical history. This could result in a considerable hike in insurance premiums or even policy cancellation. Moreover, most dental offices file the claim to the insurance company, and it is doubtful that they would mistakenly mislead the insurance company about the date of service.

In short, honesty is always the best policy for filing insurance claims. It’s essential to follow the insurance company’s rules and regulations and not engage in fraudulent activities. If you have any doubts or questions about your insurance policy, it’s always a good idea to contact your insurance provider for clarification.

Ultimately, the decision is up to you. It may be worth weighing the pros and cons of waiting for insurance coverage versus paying for the crown out of pocket and considering any payment options that may be available to you.

Consider a Temporary Crown for Your Chipped Tooth: Benefits, Insurance Coverage, and Advice from Dentist

You could discuss with your dentist the possibility of getting a temporary crown until your waiting period is over. Temporary crowns are acrylic and designed to protect your chipped tooth, maintain your bite, and prevent further damage until the permanent crown is ready.

Temporary crowns are typically much less expensive than permanent crowns, which could make them a more affordable choice for you. Some dental insurance policies cover the cost of temporary crowns, even during the waiting period before placing a permanent crown. It’s always a good idea to check with your dental insurance company’s member service to verify if they cover temporary crowns. If they do, it can help you make an informed decision about your dental care and save you money. Feel free to ask your dentist about the pros and cons of temporary versus permanent crowns and which option might suit your situation.

However, it’s essential to remember that temporary crowns are less durable and long-lasting than permanent crowns and will eventually need to be replaced. Your dentist can advise you on whether a temporary crown is the best option for your situation and help you make an informed decision.  

Getting a Dental HMO Insurance Plan

An alternative solution to consider when needing a crown during a waiting period is to purchase a dental HMO insurance plan that does not have waiting periods. This option can help reduce the crown cost if you have yet to start any work on the tooth that needs the crown. 

However, it’s important to note that this may require you to change to a different dental office that accepts the HMO plan. Fortunately, many dental offices accept HMO plans, so finding a new provider that meets your needs should not be difficult. Be sure to consult with your dentist and insurance provider to discuss this option and determine whether it is the right choice.

Dental Discount Plan May Help You Save Money During a Waiting Period

Dental discount plans are an alternative option that can help you save money on dental services, including crowns, during a waiting period. These plans are not insurance policies but membership-based programs offering discounted rates for dental services. 

Dental discount plans typically have no waiting periods and can be used immediately. You can enroll in a dental discount plan and access discounted dental services, including crowns, immediately, even if your current dental insurance plan has a waiting period.

One of the benefits of dental discount plans is that they often offer significant discounts on dental services. The discounts can vary depending on the plan and the provider, but they can range from 10% to 60% off the regular cost of dental services. 

Another advantage of dental discount plans is that they are generally easy to use. Once you sign up for the plan, you can present your membership card at the dental office to receive the discounted rate. No claim forms or waiting periods; you can use the plan as often as needed.

It’s important to note that dental discount plans are not insurance policies, so they do not cover the entire cost of dental services. Instead, they offer discounted rates to help you save money on dental care. Dental discount plans may be a good option for people who do not have dental insurance or who have a waiting period on their current dental insurance plan.

Cash Discount May be an Option 

If you choose to get the dental crown during the waiting period, it’s worth discussing with your dentist whether they offer a cash discount for services not filed with insurance. Some dental offices may provide a discount for patients who pay in cash, saving them the time and cost of filing an insurance claim. It’s always a good idea to ask your dentist about any discounts or payment options.

Additionally, a cash discount could help you save money in the long run, especially if you don’t plan on using your insurance for any other dental procedures during the waiting period. However, it’s essential to remember that not all dental offices offer a cash discount, and the discount amount can vary. 

Therefore, it’s essential to discuss the cost of the crown with your dentist and any payment options available. Being transparent with your dentist about your financial situation can help them better understand your needs and find ways to work with you to provide the best possible care.

Finding Affordable Dental Insurance Plans with Dental4Less.com

In conclusion, waiting for insurance coverage for necessary dental procedures can be frustrating, but it’s essential to avoid committing insurance fraud. Filing a claim with false information can lead to severe consequences, including policy cancellation, legal action, and a considerable hike in insurance premiums. Therefore, it’s crucial to consider alternative options when needing immediate dental care, such as payment plans, temporary crowns, or purchasing a dental HMO plan without waiting periods.

Dental4Less.com offers a wide range of dental plan types that can assist you in finding an affordable and reliable dental insurance plan that meets your specific needs. Our team of experts is available during business hours of M-F 8-4, and we’re always happy to help. We understand that dental care can be expensive, and we aim to provide options that make it more affordable while ensuring you receive the care you need.

We believe honesty is always the best policy when filing insurance claims. Therefore, we encourage you to avoid fraudulent activities and follow your insurance company’s rules and regulations. If you have any questions or doubts about your policy, please don’t hesitate to contact your insurance provider for clarification.

In summary, exploring alternative options and finding a dental insurance plan that meets your needs is a better and more honest approach than filing a claim with false information. Dental4Less.com can help you find affordable and reliable dental insurance plans that fit your budget and dental care needs. Contact us today at 310-534-3444 during our business hours of M-F 8-4, and let us assist you in finding the right plan for you.

You should think ahead when getting dental insurance.

It may seem surprising that many people do not have dental insurance. However, dental insurance benefits are only sometimes offered through work, so people do without until a significant dental need arises. The problem with waiting until you need dental insurance is that it can be too late to get the type of dental insurance you want. You may need a dental PPO plan to stay with your dentist.

However, most dental PPO plans have long-term waiting periods, so you may not get the coverage you seek when not bought early. If you have a dentist you do not wish to change, find out what dental plans you would need to stay with their dental office. If you are with a dental office that only accepts PPO dental plans, you should consider getting a PPO plan now to have a plan in place for your future dental needs, whether for preventive dental care or major dental care.

California Oral health care, Red and sore gums

I recently noticed that my gums have been hurting slightly and seem redder than usual. I brush twice a day and floss almost every day. They do not bleed when I am doing that but they just kind of hurt when I do. Could I have gum disease?

Reply: Some of the start signs of gingivitis (gum disease) would include but are not limited to, Swollen or puffy gums, Dusky red or dark red gums, and tender gums. I suggest visiting your dentist as soon as possible, so if you have the start of gingivitis, your dentist can treat it before it becomes a more significant issue. Consider buying dental insurance if you do not have any current, as it will help to keep your dental care cost more affordable.

I do not have current dental insurance and very little money. My dentist told me I needed dental work on my teeth, so I started looking for dental insurance. Right now, insurance seems too costly for me, but some friends tell me to avoid dental discount plans because they are not insurance. Is this true?

Reply: That is correct. Dental discount plans are not insurance. Dental discount plans help you save money on your dental care cost as long as you go to a dentist who is a provider of the plan. Discount plans are an excellent way to help make dental care more affordable at a low cost. If you want dental insurance, consider reviewing dental HMO plans. Dental HMO plans are the more affordable dental insurance option.

Are Individual PPO Dental Insurance Plans worth buying?

Some people may feel that getting dental insurance is not worth the plan’s cost. That may be true for some dental insurance plans if the person wanting it only wants the dental insurance for short-term use. Many people put off their dental care until they are in pain or have significant dental issues. Then get upset when they find out that many PPOs or Indemnity insurance plans have limitations that will not be able to help them with their major dental care needs immediately. A dental PPO plan is not for those who only want to buy a dental insurance plan to fix a current dental issue and then turn around and cancel the plan once they have their dental work done. The reason is that dental PPOs are designed to be long-term plans and not short-term ones. When considering buying a dental PPO or Indemnity plan, the thing to keep in mind is your long-term dental needs. When getting these types of insurance plans, it is a dental plan you want to keep for at least a few years.

PPO Full Coverage Dental insurance for a dental crown

Question:I require two dental crowns. I seek a dental insurance plan covering at least 50 percent or more on a crown and one without waiting periods. Is there a dental insurance plan like that?

Reply: We have two options for you; any of our HMO dental insurance would work. On the HMOs we provide, there are no waiting periods. The crown’s cost typically ranges from $100.00 – $250.00+. Another option would be our Delta Dental PPO plan. That does not have waiting periods; however, the first-year benefits on majors services such as crown run around 10 to 15 percent, and you only have 50 percent benefits on majors services once you have the plan for three years.

Dental care, Indvidual dental Insurance for Texas.  I am moving to Dallas Texas in the next two months to live with my girl friend.  I already got a job transfer but my job does not offer me dental benefits.

I am wanting to buy a dental plan for myself  but since I am will be new to Texas dental office is not really much of an issue.  I just need a dental plan that will offer adult braces.  I have been saving up for braces now for the past three years and think I can afford them now with the help of a good dental plan.

My mom will not get my teeth whiten nor will she pay for any over the counter whiten strips or let me use them.   About the only thing she has agree to was getting me toothpaste with whitening.   I really want my teeth to be really white.

So if I brush longer and more often though out the day will the toothpaste whiten my teeth faster then just brushing normally?

I take sleeping pills when needed since normally I do not sleep and I am a very light sleeper.  Since I know having all four wisdom teeth pulled is going to be painful for days I also know I will never get to sleep if I am in pain.   Where can I make sure this is okay?

Connecticut Dental Care: For a long time now I hear people staying how our old silver filling are really bad and should be removed.   I have like six or seven old silver fillings.   I got them when I was a kids.  I am no longer a child and I have had my filling for many years without any problems.   Should I really be worried about then now?

OMG my best friend has had bad breath for almost as long as I know him.  I am 15 and my other friends always make fun behind his back.  I really do not know what the issue is and why he had bad smelling breath.

I did off handly asked him once and he said he does not know since he brushes his teeth every morning.  I did not want to continue talking about it because Idid not want to hurt his feelings.  He has nice looking teeth so it not like he has yuck mouth or anything.

Is there anything he can do that I may be albe to bring up again?  My girl friends are starting to get on me about it and although I have know him for a long time now I do not like being made fun of because I have a friend that stinks.

I know that some people say that brushing with baking soda will help to whiten your teeth and that cool and all but will it help my bad breath?  I was told if I started brushing with baking soda it would totally get rid of bad breath but I would have to use it all the time I brushed.

Would that mess up my teeth if I do that?  I think I saw that over use of baking soda could damage your teeth.  I feel that I a  damn if I do or damn if I do not.  What is right

I never had to have any major dental care.  I take really good care of my teeth by brushing three times a day and flossing not only that but I see my dentist four time a year for checks and cleaning.  I can not stand bad teeth whether they are mine or someone else’s.

My dentist told me that my bottom two wisdom teeth needs to be pulled soon before they start coming out since they are a little sideways they will start to cause problems.  For some reason I only show that I have bottom wisdom teeth in the X-Rays but not top ones.

Anyway I am a little scared over this event and even though I made an appointment what should I expect?  Is it painful and if so how long normally

So I am kinda new to having braces and I am still using the wax  so I will not cut myself up.  My problem is my dog got to what I have left and I do not see the Orthodontic dentist for another month.

His office is over 20 miles away so I can not get there on my own and my mom will not take me before my appointment.  Is there any other place I can go to get some dental wax for my braces?

New York Dental Care: Hello,   about two year ago I had a bridge put in towards the back top part of my mouth.  Can I remove the dental bridge and just go without?  I think it is causing me to have bad smelling breath.  Since the teeth are in the back no one would really notice I do not smile so big as to see it anyway.

I am thirty and my teeth have always been really sensitive to hot and cold.  The dentist told me once I just have thin tooth enamel.  When I was in my teens my mom had the dentist put on dental sealants for just a few of my front teeth.  It really helped out a lot.

Can I have dental sealants but back on my teeth so they will not be so sensitive?  And how do I make sure my current dental insurance plan I get though work will cover it or not?

I will be getting a dental discount plan my dentist  told me about which was how I found your website.   The thing is I have four missing teeth that insurance will not cover but my dentist takes the Careington dental plan which I bought here from you.

I need as much information as I can get on a having a dental bridge done.  Is having a bridge comfortable?  Will it hurt having it put on? Will the bridge look just like my teeth or will people know I have it?

My dentist get on me every time I come in that I am not flossing good enough.  I have no cavities and never needed major dental work done.  However each time he tell me flossing good for my gums and I need to do it better and more often.

Yet every time  I floss my gums hurt afterwords.  They would be sore for a few hours and they do bleed when I floss so I do not really like flossing at all and I only brush three times a day to make up for it.  I just do not see how it can be good from my gums if it makes my gums hurt.

I went to the dental and was told I have a hole in my back molar.   I am to go back in two weeks to do a full evaluation but right now it looks like I will be needing a root canal and crown done.  I did not have it done at the time because I only went in for a cleaning and had very little time left before I had to go to work.

I am not in any type of pain from this tooth but I am worried that the tooth decay will get worse and cause my molar to brake for the next dental visit to fix it.   Is there anything I can do to protect the tooth until then ?  Advise please.

Two months ago I got porcelain veneers on my front teeth and I am wondering if it is normal for the edges of the veneer to get rough?  Towards the bottom they seem a little rough.  I do not recall them being like that when I first got them on.  Also they are not as shinny as when I first had them put on two months ago.    Should I go back to the dentist and complain?  Did I get bad Veneers?

Since I first got my adult teeth I had some white spots on my teeth.  I am 21 now and really do not know why they are there.  I tried using whiten strips thinking it would whiten up the rest of the teeth making so you do not see the white spots but it really did not work.

My dentist never says anything about the spots so I guess they are not bad and I have good teeth with no cavities.  Is there any way to make the white spots leave?  Just wondering if there is anything I can do about them.

Hello I am 20 and going to be a first time mom in another six months.  Right now I do not have any dental insurance only medical though my job.  My live in boyfriend does not have any dental insurance either but we both want it for our child.

My question would be if we buy dental insurance when the baby is born can we get a family plan with all of us?  Or dose one of get a couple plan with the the baby and the other has to get their own plan if they want?  Not sure how it get broken down since we are not married and do not plan on getting married any time soon.

I been having this toothache that is a dull pain for the past four days non stop.   I am not sure if it is only a cavity or what.  I do not have dental insurance and do not know if it is too late for me to get some because I am not sure if I can wait it out.  Can you offer up some advise on what to do to kill the pain until I see a dentist.

Hi I am looking for a very fast way to reduce the swelling in my cheeks from having my wisdom teeth pulled.   I had all four pull two days ago and I still look like a chipmunk.  I have a party I like to go to and I do not want to go looking so bad.  Is there any way to reduce the swelling in six hours from now?