Dental Insurance – Dentist Kitsilano

“Dentists treat you, not your dental plan.”

Dental plans are valuable components of extended health benefits, and are designed to offset the cost of dental treatment. At Kits Family Dental, we strive to help patients understand your dental insurance, so you can make informed choices regarding your dental treatment.

What is the dentist’s responsibility with regards to working with insurance plans and coverage limits?

Your dentist or dental specialist is highly trained and suggest treatment recommendations based you’re your specific dental health needs, not dictated by your dental coverage. A Dental plan is a contract between a third party (like your employer), and the insurance company. The procedures and percentages covered are determined by the contract, not your dentist.

At Kits Family Dental, we help our patients understand your coverage and assist you in getting pre-authorizations for treatment. This will provide you with a good estimate of what will be covered by your plan, and what your costs will be—before the treatment begins.

What is the patient’s responsibility regarding dental plans?

It is your responsibility to know your plan coverage, including any changes. Ask your benefits manager or insurance provider for a plan booklet, or online website on your specific coverage. Please inform the receptionist of all your plan details before your appointment, and we will also do our best to find out your coverage information for you. However, many plans will not release information to dental offices, and will only release detailed coverage information to the insurance plan owner—you!

What do most insurance plans cover?

Regardless of the actual costs, most dental plans cover between 50% to 80% of the cost of dental care. Any portion of the price not covered by your plan is your responsibility. The claim form that we submit to your insurance company on your behalf is a contract.

As a service to the patients at Kits Family Dental, we immediately submit your dental insurance claim to your insurance company electronically. The full cost of procedures will be collected at the time treatment is provided, and your insurance company will reimburse you directly for what is covered by your plan.

Can I request that my dentist only provide care that’s covered by my plan?

Your dentist is obligated to treat you, not your dental plan. Treatment recommendations are based on your dental health needs, which may differ widely from what your plan covers. You have the right to accept or refuse treatment but ensure you understand the implications that refusing or delaying any recommended treatment may have on your health. Base your decision on an informed discussion with your dentist around your dental needs. This decision can impact your health and should not be dictated by your dental plan coverage.

How are dental costs determined?

The BCDA produces an annual suggested fee guide for dentists and dental specialists in BC. The majority of insurance plans determine coverage percentages on this guide. Dentists and dental specialists in Canada do not have to follow a fee schedule and must set their prices to cover: lab costs and quality materials required for your procedure paid for directly by the dentist; salaries; rent; mandatory continuing education requirements; equipment; and all other business costs related to running a dental practice. Kits Family Dental follows the BCDA’s suggested fee guide.

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