About dental insurance
During your visit, our secretary will ask you for your insurance details for the transmission of your documents and for invoicing electronically. It is important to know, however, that insurance companies only discuss with the insured person and do not contact the dental clinic. We can prepare for you the estimates and claims to be forwarded to your insurance company, but the answers will usually be directed to you directly.
When your insurance plan allows it, an electronic transmission is processed the same day of care and your insurance company will pay their share directly to the dentist.
Here is some general information about dental insurance:
- Each patient is responsible for informing their dental insurer of details related to their insurance plan. Patients can get help from the dentist office to better understand their plan and ask relevant questions to their insurer. Many insurance companies will not tell us directly about your coverage details.
- Each member of the same family has the amount of insurance provided for in the package and this amount is not transferable to anyone.
- The majority of dental insurance plans offer a limit amount per year, typically ranging from $ 1,000 to $ 2,000. The patient must follow the evolution of his dental expenses and make sure that he does not reach his limit, in which case he will have to pay the difference. Our clinic can not take on this responsibility.
- The majority of insurance companies set a prevention visit frequency (examination and cleaning) at 6, 9 or 12 months. The patient may choose to follow his insurance plan but must be aware that the frequency paid may not be suitable for his oral condition. This frequency is not related to the prescription of the dentist and his team, made according to the actual needs of the dental health of each client.
- Some insurance companies refund the price of treatments according to the rate guide of the Association des dentistes du Québec (ACDQ) of previous years. It is not uncommon to see the refund based on a tariff dating back several years.
- Some dental plans provide a deductible amount to be paid at the beginning of each year or at the start date of the contract. This amount usually ranges from $ 25 to $ 100 depending on the packages.
- Patients covered by their dental insurance for major care (crowns and bridges for example) must go through an assessment and evaluation process with the dentist of their insurance company before seeing their fees approved and reimbursed.
- Some insurance companies reimburse fees for composite resin restorations (white fillings) at the cost of amalgam restorations (gray fillings). The patient would have to pay the difference.
- Your coverage may change from year to year. It is your responsibility to inform us of these changes so that we do not have unforeseen events.