Frequently asked questions about dental insurance.
What insurance plans do you accept?
We accept all insurance plans! However, we are not a PPO provider for any insurance plan. PPO plans allow patients to select their own doctors and then reimburse submitted claims according to a set schedule of benefits. We may be "out of network" for your dental insurance, which means your out of pocket expenses may be higher than if you use a dentist within your plan's network. You should verify your insurance information prior to picking a dentist to ensure there won't be any unpleasant surprises later!
How can I find out what my insurance will cover?
There are thousands of different dental insurance plans. The best way to find out what your dental insurance will cover is to contact your dental insurance provider and ask about your benefits. You may be able to find what you need on their website, or you may need to call customer service and speak to a representative. Your company's HR department may also be able to provide you with information. Some big companies have a representative who handles dental benefits exclusively.
What is a "fee schedule"?
The first place to start when trying to determine what is covered is to get your insurance company's "Fee Schedule" or "Schedule of Benefits." This is a list of dollar amounts that they cover for each procedure. For example, the "usual and customary" amount an insurance company will pay for Dental Procedure X is $75. If your dental office charges $100 for this procedure, you will be responsible for the $25 difference.
Why won't my insurance company cover everything?
Dental insurance is far less robust than medical insurance. Dental insurance generally covers preventative dental care and maintenance of existing dental work, but not much more. Overall, it is rather inadequate, not comprehensive, and will only cover the bare minimum. There is usually a maximum yearly dollar amount they cover (the industry average is about $1000). The patient is responsible for any treatment costs over the yearly maximum.
Dr. Emam is focused on comprehensive care, and this encompasses more than the "bare minimum" covered by insurance companies. Dr. Emam doesn't work for an insurance company; she works for you, the patient. She will always be straightforward about the dental care you need, and that may or may not match up with what your insurance company will pay for.
What if I don't have dental insurance?
There's no need to worry. We work with all patients to create a long-term plan for your dental health, and we customize treatment based on your budget. Think of this dental health "master plan" as you would a to-do list for a dream house. You complete the house one phase at a time. One tooth or procedure is done at a time in order to achieve your long-term dental health goals.
Who should I talk to if I have questions?
You can call our office at (650) 321-0340 and we will be happy to talk through any insurance questions you have. We are always your advocate for the insurance process!